What Is the Prostate?
The prostate is a small gland, roughly the size of a walnut, located just below the bladder in men. It surrounds the urethra — the tube that carries urine from the bladder out of the body — and produces some of the fluid that makes up semen. Prostate cancer develops when cells within the prostate gland begin to grow abnormally. It is the most common cancer in men, with about 1 in 8 men receiving this diagnosis in their lifetime. Of critical importance to Nigerian men: men of African descent have the highest rates of prostate cancer in the world — not just a slightly elevated risk, but significantly higher rates of diagnosis and significantly higher rates of aggressive disease compared to men of other backgrounds. This is not widely known, and that gap in knowledge contributes directly to late diagnoses.
Why Early-Stage Prostate Cancer Shows No Symptoms
Prostate cancer, in its early and most curable stages, is essentially invisible. It causes no pain, no change in the urine, and no noticeable change in how a man feels. This is what makes it dangerous and why waiting for symptoms before seeking assessment is a strategy that fails many Nigerian men. By the time symptoms appear — urinary symptoms, bone pain, weight loss — the cancer has in many cases already spread beyond the prostate, making curative treatment far more difficult. The majority of Nigerian men who are eventually diagnosed with prostate cancer present at an advanced stage. This does not have to be the norm.
Symptoms That Demand Investigation
- Difficulty starting to urinate, or needing to push or strain to get the flow going
- A weak, slow, or intermittent urine stream
- Feeling that the bladder is never completely empty
- Needing to urinate much more frequently than before, especially at night
- Blood in the urine or in semen
- Burning or pain during urination
- Persistent pain in the lower back, hips, pelvis, or thighs (this may indicate cancer that has spread to bone — do not delay)
- Important: these symptoms can also be caused by a non-cancerous enlarged prostate (BPH), which is very common in older men. Only a doctor can determine which it is — and they are not the same thing.
Who Should Discuss Screening and When?
- Nigerian men of African descent should begin conversations with their doctor about prostate cancer screening from age 40 — not 50, as is sometimes advised for other groups
- Any man with a first-degree relative (father or brother) who has had prostate cancer should begin these conversations earlier still
- The PSA (Prostate-Specific Antigen) blood test is the main screening tool — it is not perfect but it is the best available
- A digital rectal examination (DRE), though widely avoided due to embarrassment, provides additional clinical information and takes less than one minute
- Screening is a conversation, not a command — your doctor will explain what the test can and cannot tell you, and what the options are if it is abnormal
The Embarrassment Factor — A Word to Nigerian Men
Prostate cancer kills Nigerian men partly because of the disease itself and partly because of culture. Men do not discuss urinary symptoms with their wives, do not mention it to friends, and do not go to a doctor until they genuinely cannot urinate. A man who would immediately take his car to a mechanic at the first sign of a strange noise will ignore his own body for years. The discomfort around the prostate examination is real but takes less than a minute. The discomfort of advanced prostate cancer lasts considerably longer. Having a PSA blood test and — if indicated — a rectal examination is an act of self-respect, not an embarrassment.
How Doc on Wheels Can Help
A PSA blood test can be arranged at your home through Doc on Wheels — no clinic visit required. Our doctors can discuss your result with you, explain what it means in the context of your age and risk factors, and refer you to a urologist urgently if there is any concern. For men who have been putting off investigating urinary symptoms or who have never had a prostate assessment, the Doc on Wheels app removes the barriers. Your life is worth 10 minutes of attention.