Understanding prostate cancer: conversation with an expert

“You may not feel any pain in the body, but I advise you to go for regular check-ups.”

In Summary

•Approximately more than 3000 men are living with prostate cancer in Kenya. 

•Mugambi says people with prostate cancer may develop symptoms such as painful or burning urination, blood in their urine, trouble getting an erection, painful ejaculation, less fluid when they ejaculate, and sometimes blood in their semen.


Being diagnosed with prostate cancer under the age of 50 is not common nowadays.

But this is what happened to ‘Kelvin’ not his real name, a resident at Kahawa Sukari, Nairobi, in 2020.

Kelvin, 36, was diagnosed with localized prostate cancer at a time when the pandemic struck.

“One day, I noticed blood in my urine. It happened only twice, so it was not much of a concern for me. I just thought it was the medicine I was taking, a mere infection or my drinking habits,” Kelvin told the Star.

“After it happened the third time, I knew I had to seek professional help. I went to the hospital, explained my symptoms, and was referred to a urologist at a private hospital.”

After a series of scans and blood tests, Kelvin received news that they had to do an emergency biopsy.

“After everything was done, they sent me home and said they would reach out to me after the tests were out. After 3 days, I went back to pick my results and that is when I was told I have prostate cancer.”

Kelvin was then given loads of information and different options but he could not think of anything since he was in complete utter shock.

“I opted for surgery which helped but they were not able to remove all cancerous cells. The doctors said it had begun spreading to my bladder and bowel," he says.

The doctors recommended he starts radiotherapy for 32 weeks.

“I remember asking myself questions like, ‘Why me, ‘I wish I never went to the hospital'. It was tough but I found that it helped to have a positive attitude. Therapy plus being close to my family also helped,” he said.

Image: Dr. Mugambi

Approximately more than 3,000 men are living with prostate cancer in Kenya. 

According to Dr Marshal Mugambi of Neema Hospital in Kahawa Sukari, the prostate is a gland found underneath the bladder of men and produces fluid that makes up a part of semen. It surrounds the tube that carries urine out of the body.

“The exact number of people with prostate cancer is unknown, but the prevalence is 40 to 50 per cent. This is among every 10,000 people, 40 to 50 people may be having cancer,” Mugambi said.

“Men and in particular those above the age of 50 are at a higher risk, but we have recently seen the number decline to even those below 50 years as so many people are not screened for it until they show symptoms. ”

Mugambi, however, advised men to seek professional help and second opinions in case they are diagnosed with prostate cancer.

This is because the symptoms of prostate cancer and normal and enlarged prostate may often have similar symptoms such as the urgent feeling to urinate many times or even trouble to start to urinate.

“Most patients may begin displaying these symptoms of a Urinary Tract Infection which often brings the ‘straining’ or ‘irritation’ but seeking proper medical attention instead of self-diagnosis may be key to finding the answer,” he said.

“Having an enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. An enlarged prostate is often called benign prostatic hyperplasia (BPH). It is not cancer, and it does not raise your risk for prostate cancer.”

How does the condition come about

Mugambi says people with prostate cancer may develop symptoms such as painful or burning urination, blood in their urine, trouble getting an erection, painful ejaculation, less fluid when they ejaculate, and sometimes blood in their semen.

“All cancers begin when cells start to multiply out of control. Cancer is caused by changes to the DNA, the genetic material that controls cell growth. This DNA, you can inherit from your parents or the changes can develop with age or lifestyle conditions like smoking, poor diet, or a minor factor like not having a recurrent ejaculation.”

Several studies have found that greater ejaculation frequency is associated with a reduced risk of prostate cancer.

One theory is that ejaculation rids the prostate gland of cancer-causing materials, infections and matter that can cause inflammation.

But despite strong evidence in favor of frequent ejaculation, the theory remains controversial. Mugambi said more research was needed to better understand the relationship between prostate cancer and ejaculation.

Mugambi advised men not to wait for symptoms to go get checked – having regular checkups is key.

Treatment options

“Once we have diagnosed a patient of prostate cancer, we must know which stage the cancer is, the size of the prostate, and how severe your symptoms are before we give you the treatment options,” Mugambi says.


For mild to moderate symptoms, your doctor might prescribe medicines to destroy cancer cells located in other parts of the body.

However, if the cancer is advanced, they may opt for surgery, chemotherapy, or radiotherapy. Some men may opt for their prostate to be removed in the worst cases.

Most men are diagnosed with prostate cancer in their senior years and only 1 out of 36 men die from it.

Death from prostate cancer most often happens when cancer has spread (metastasized) to other organs in the body. This is known as the advanced stage of prostate cancer.

Care for prostate cancer patients

“It is worth noting that anybody is at risk of getting prostate cancer. Going for regular checks might be the first step to knowing if you are at risk,” he said.

Mugambi advised those diagnosed with cancer to seek psychological support.

“Men with prostate cancer may get depressed before and after treatment. Depression symptoms are often accompanied by feelings of unhappiness and hopelessness to losing interest in things. You can recommend a counsellor specially trained to offer advice or help them join support groups, with the help of the hospital,” he advised.

Mugambi noted that the Kenyan Government needs to create more awareness of the condition, especially in rural and marginalized areas where people are suffering silently.

“We need more forums that advocate for prostate cancer as much as we advocate for breast cancer, this will help create awareness and deal with the stigma that is often associated with prostate cancer,” Mugambi said.

He advised observing a balanced diet and good hygiene may help reduce chronic inflammation and infections which are associated with an increased risk of prostate cancer development.

He encouraged Kenyans to have National Health Insurance Fund (NHIF) cards to help them ease the burden of accessing health services, especially cancer and other chronic diseases that were a bit expensive.

How the test is conducted

“Your doctor may conduct a Digital Rectal Exam, which is not quite comfortable. Your doctor will insert a gloved lubricated finger in your rectum to see if your prostate is enlarged or abnormally shaped. But more tests are needed after this is done,” he says.

Mugambi says a PSA (Prostate Specific Antigen) blood test may be conducted next. The blood test checks if the protein your prostate produces when it grows is a lot.

A high PSA level can only tell your doctor that your prostate has grown. It cannot tell for sure that you have an enlarged prostate or prostate cancer. So further tests have to be carried out.

“Your doctor may conduct a pelvic ultrasound or CT scan to make pictures of your prostate gland or do a biopsy to get samples of your prostate tissue and check it under a microscope for cancer,” he said.

With each test approximating Sh2,000 to Sh4,000 depending on the hospital, Mugambi said doctors may use many of the same tests to diagnose the condition.

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