Prostate Cancer and PSA Screening
Prostate cancer is one of the commonest cancers in Nigerian men, and men of African descent tend to get it younger and in a more aggressive form. Early prostate cancer usually causes no symptoms, which is why many men in Nigeria are first diagnosed when it has already spread to the bones. Found early, it is very treatable. The PSA blood test and an examination by a urologist are how it is found early.
Find a Urology SpecialistMedically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- Often no symptoms in the early stages
- Weak stream or trouble passing urine (also caused by an enlarged prostate)
- Waking at night to pass urine
- Blood in the urine or semen
- Bone pain, especially in the back, hips or ribs
- Unexplained weight loss and tiredness
- Weakness or numbness in the legs (a sign of spread to the spine)
When to See a Doctor
Talk to a doctor about a PSA test from about age 45, or from 40 if your father or brother had prostate cancer. See a urologist promptly if your PSA is raised, if you have new urinary symptoms over 50, or if you see blood in your urine or semen. Go to an emergency department the same day for back pain with new weakness or numbness in the legs, or loss of control of the bladder or bowel.
Treatment options
- Active surveillance for small, slow-growing cancers, with regular PSA tests and MRI
- Radical prostatectomy (removal of the prostate)
- Radiotherapy
- Hormone therapy (androgen deprivation) for advanced disease
- Chemotherapy and newer hormone medicines when cancer has spread
- Treatment of bone pain and other complications
Common Questions
What is a normal PSA level?
There is no single cut-off that fits every man. PSA rises with age and with an enlarged prostate, infection, recent ejaculation or cycling. Results above about 4 ng/mL are commonly followed up, and a urologist reads the number alongside your age, prostate size and how fast it is rising.
Does a high PSA mean I have cancer?
No. Most raised PSA results are not cancer. The next step is usually a repeat test, an examination and, increasingly, an MRI scan of the prostate before deciding whether a biopsy is needed.
How is prostate cancer confirmed?
Only by a biopsy, in which small samples of the prostate are taken with a needle and examined under a microscope. The result gives the cancer a grade (the Gleason score), which with the PSA and scans decides the treatment.
Is prostate cancer a death sentence?
No. Cancer found while still inside the prostate is often cured, and many slow-growing cancers need only monitoring. Even when it has spread, treatment can control it for years. The problem in Nigeria is late diagnosis, which is why testing before symptoms matters.
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