His prolonged battle with the killer disease for five harrowing years was one that took him through excruciating medical crucibles.
Sadly, he lost four of his family members in quick succession, shortly after they were diagnosed at an advanced stage with the debilitating ailment.
He shares his journey to recovery with ANGELA ONWUZOO and gave insights into how men can win the battle against the scourge.
When Captain Ayinde Yahya (retd) lost his voice in 2019 after taking part in a rigorous presidential election campaign with his kinsmen in Ilorin, Kwara State, little did he know that it was prostate cancer that was stealthy, sinking its fangs into his body.
the life-threatening disease was not new to the retired army officer, who had lost his father, uncle, and two of his brothers to the killer disease.
The soft-spoken father of 10, told our correspondent that what he found strange about his ordeal was that he did not experience classical symptoms of the disease, such as difficulty in urinating and back pain, which were what his late loved ones painfully endured before succumbing to the degenerative disease.
Instead, Capt. Yahya battled with excessive fatigue and loss of speech for over eight weeks, within which time people around him struggled to hear the inaudible words he uttered.
House sold to upset treatment
The grandfather, who sold his house in Ikorodu area of Lagos State to pay for his treatment, said it was tough surviving the ailment after it was diagnosed at an advanced stage.
He recounted, “When I realised that my condition was not getting any better, I told a doctor during one of my visits to the clinic that I have been unable to carry out my Prostate-Specific Antigen test in the last three years.
“So, he referred me to an urologist. The urologist gave me a letter to go carry out the PSA test. The result showed that it was 150, instead of 4.5. That meant I was already dead. I was a living corpse.”
The septuagenarian said he could have escaped the invasion of the ravaging disease and its huge financial burden if he had continued with his PSA screening.
The retired Army officer told Reportr Door Health that he was, however, lucky to have survived the deadly disease by selling his house to pay for treatments and drugs.
Narrow escape
The Kwara State indigene recalled that from the age of 50, he started carrying out prostate cancer tests every two years.
“I was living in my own house in Ikorodu, Lagos, before my prostate cancer journey forced me to relocate to Kwara State, after selling the property to access treatment.
“I started carrying the prostate cancer screening test also known as the Prostate-Specific Antigen test at Ikorodu General Hospital. But then, each time I go for the PSA test, the result will return negative. So, after carrying out the test for 10 years and the result kept coming back negative, I stopped.
” I felt the test was a waste of time and money. But I was wrong. The three-year period that I refused to go for the PSA test was when prostate cancer struck me. I was almost gone because I was diagnosed at an advanced stage of the disease.”
Prostate-Specific Antigen Test explained
The Prostate-Specific Antigen test popularly known as the PSA test, according to an online news portal, Mayo Clinic, is a blood test used primarily to screen for prostate cancer.
It explained that the test measures the amount of prostate-specific antigen in the blood.
“PSA is a protein produced by both cancerous and noncancerous tissue in the prostate- a small gland that sits below the bladder in males”, Mayo Clinic stated.
According to the Prostate Cancer Foundation, the PSA test is the leading method of screening for prostate cancer.
Experts say PSA screening can help detect the disease at an early stage when treatment may be more effective and potentially have fewer side effects.
Despite the availability and affordability of the PSA test, physicians say most men in Nigeria die from prostate cancer due to low awareness about the disease.
Although Nigeria lacks data on the number of its populace living with prostate cancer, findings by Reportr Door Healthwise showed that prostate cancer is the most commonly diagnosed cancer among men, but screening for the disease is not yet a common practice in the country.
Yahya who chronicled how his prostate cancer journey, which started in 2018 with a complete loss of his voice, told our correspondent that he initially thought that the challenge he had with his voice was caused by a sore throat, without knowing that it was one of the symptoms of full-blown prostate cancer.
Headache and twisted tongue
Further chronicling his battle with prostate cancer, the retired Army officer said, “In 2018, I woke up from sleep with a severe headache and a twisted tongue. I was still living in Lagos at that time. So, I drove myself to Ikorodu General Hospital, where the doctor attended to me and gave me some drugs.
” After a month, I became okay. A year after, in 2019, I got involved in a presidential campaign in my state that was so tedious I had to shout most of the time. So, I lost my voice.
“Initially, I thought I had a sore throat. I started taking bitter kola with honey and there was no respite. After some time, it got worse that nobody could hear me anymore, no matter how close they were to me.
“I lost my voice completely. One day, while still battling to recover my voice, I started feeling very weak and couldn’t walk. I was rushed to the University of Ilorin Teaching Hospital, Kwara State.”
Continuing, he said, “After I was given some treatments at the emergency department, I was referred to the neurology department, where I was administered some drugs and felt better. My voice became normal. But around July of that same year, I had a relapse. I started stooling uncontrollably and became so emaciated.”
The retired Army officer who is a grandfather of 11 grandchildren, told Reportr Door Healthwise that prostate cancer almost paralysed him, as he could no longer carry out his routine chores without the support of his children.
” My daughter and sons were the ones taking turns to bathe me. I could not walk or stand. So, I went back to the UITH and my case was moved from the Neurology Department to the Ear Nose and Throat Department.
Doctors unaware it was prostate cancer
“After examining me, the doctors requested for Magnetic Resonance Imaging to be carried out at the Mecure Healthcare Centre, Oshodi, Lagos. When the MRI result came out, it indicated that the problem had to do with the throat and not neurology. A growth was discovered in my throat.
“So after the doctors at the ENT department saw my result and had it analysed, I was taken to the theatre, where they operated on my throat. They took part of the tumour for a test and it was not cancerous.
The Septuagenarian said the doctors told him that since it was not cancer and his voice was still not clear, he should start taking his medications with warm water.
“They assured me that my voice will become normal with time. At this point, the doctors were still not aware that I had prostate cancer and that it was responsible for my ill health”, he added.
Worried that he was not getting better after carrying out the surgery, the septuagenarian, said he decided to help the doctors to do their job by requesting for a prostate cancer screening, having stopped for over three years.
His suspicion was right as his PSA test showed that prostate cancer had invaded his body and was now at an advanced stage.]
“The test confirmed my suspicion,” Capt.Yahya said with a smile on his face.
Prostate cancer leading cause of cancer death in black men
Experts say prostate cancer is a leading cancer diagnosis and cause of cancer-related deaths among men.
They noted that it is the most commonly diagnosed cancer among Nigerian men.
A Professor of Pathology, Oncology and Urology at the Johns Hopkins School of Medicine, Clayton Yates told Reportr Door Healthwise in an exclusive interview that based on available statistics, 60 per cent of black men are more at risk of prostate cancer than white men.
“We have done research that showed that there are possible genetic hereditary genes that are in people of African descent that predispose them to prostate cancer.
“So, before you even get diagnosed, you have to live a healthy lifestyle, eat lots of fruits and vegetables. Eight out of 10 African men will have prostate cancer, while it is between four and five out of 10 for white men. For black men, they must start prostate cancer screening from the age of 40 years”, the oncologist said.
Further narrating his ordeal, Capt. Yahya said when he realised that, “Several other tests revealed that it was an advanced prostate cancer.
“I was asked to carry out an MRI and the UITH, but the machine was not available there. So, I went to Ladoke Akintola University Teaching Hospital, Ogbomoso, Oyo State and it was done for N120,000.
“The result further revealed that the prostate cancer was at an advanced stage, but had not affected major organs of my body, though it had metastasized.
“When I went back to the consultant that requested for the MRI test, he examined me and prescribed three treatment options. They were either I get castrated, have my testicles removed, or I will be on a monthly injection every three months.
Why I refused castration
The grandfather told our correspondent that he refused to be castrated due to the complications involved.
He said, “The doctor advised me to go for the first option, which was to have my testicles removed. He explained that prostate cancer feeds on the testes and that if I should remove them, the cancer will die a natural death.
“But I refused to be castrated because I have seen the elderly with prostate cancer, who were castrated and had complications. Some of them are still urinating uncontrollably. I saw some of them at the urology clinic when I was still receiving treated.
“Some of them told me that they started having problems after their testicles were removed in the course of treatment. Because of that, I refused to remove mine. That was why I chose the third option– injection.
“I take the injection every three months and a jab cost N150, 000. The doctor said the tablet will not be too effective in my case. But the side effects of the injection is traumatizing. The tingling sensation is worrisome. ”
Yahya, who went into business after his retirement from the Nigerian Army, told Reportr Door Healthwise that he received the news about his prostate cancer with calmness, despite suffering heavy losses to the disease – the death of four family members.
“My reaction upon discovering that I had prostate cancer was to believe that I will not die until it is my time,” he added gleefully.
Life is more important than sex
The septuagenarian said despite losing his ability to become intimate with a woman, he is happy to be alive.
“Despite the fact that I was vomiting every food I ate, I still have a strong spirit that I will survive the disease. I stopped having sex after I was diagnosed with prostate cancer because life is more important than sex.
“For five years now, I have not been intimate with any woman. The prostate cancer made me to stop, even though I normally have the urge sometimes. I have four wives. The doctor didn’t advise me to stop, but I feel that as a prostate cancer patient if I have sex, it will worsen my condition. ”
“Also, the side effects of prostate cancer treatment include loss of libido and dizziness. There is no prostate cancer treatment that does not have side effects especially loss of libido.”
The retiree said the obvious prostate cancer symptoms that he had besides the loss of his voice were serious back pain and frequent urination.
“I didn’t have a problem urinating like others. Now, immediately I take the injection, by the next week, I will start talking normally”, he added.
Prostate cancer, a death knell for the poor
Capt. Yahya said surviving cancer in Nigeria through out-of-pocket payment for healthcare was tough.
“From my experience, it will be difficult for a poor man to survive prostate cancer in Nigeria through out-of-pocket payment for treatment. In fact, receiving the news that you have prostate cancer can be traumatising. Prostate cancer treatment is very expensive.
“The injection that I take is N150,000 per dose and it has to be every three months. I take a tablet every night, and I spend N40,000 every month to buy a pack of 28 tablets.
“I sold my house in Ikorodu to raise money for treatment. After I sold my house, I relocated to Kwara State. My children are the ones now paying for my treatment.
“Then also, you must always eat a good diet. Without a good diet, you can never survive prostate cancer and these diets are expensive.
Out-of-pocket payment for cancer treatment
President, Nigerian Cancer Society, Dr. Adamu Umar, in an interview, revealed that by the end of 2023, about 102,000 Nigerians will have been diagnosed with cancer, hinting that the disease is hitting closer to more Nigerian homes and families than ever.
The NCS president feared that no fewer than 40,000 of the 102, 000 Nigerians, would survive the disease.
“The world has recorded significant improvements in cancer care, yet thousands of Nigerians continue to die from the disease.
“In many countries, cancer is no longer a death sentence; with the right care, it is a chronic disease that can be managed.”
According to him, “it is clear, therefore, that there is a care gap.”
He said that cancer patients in developing countries like Nigeria groan under the crushing costs of cancer care.
“Nearly 80 per cent of Nigerians cover medical expenses out-of-pocket. The average cost of treating cancer can exceed N10 million and, over time, can reach as high as N20 million.
“Few Nigerians can afford this. Many earn less than N60,000 a month. A cancer diagnosis can leave even high-earning citizens on the brink of poverty.
“Around 70 per cent of cancer deaths happen in developing nations. This is due to inadequate care.
“In addition to the high financial burden of the disease, few facilities offer comprehensive cancer care,” he said.
Umar said that there were just not enough cancer care specialists or cancer care centres to handle this emergency.
According to him, the National Action on Sugar Reduction coalition is calling for more policy action to close the care gap.
Umar said that cancer incidence and mortality could be prevented if healthcare was prioritised in the country.
According to Professor Sani Malami, President, the Nigerian Cancer Society, the survival rates for cancers are low in Nigeria and the reason for this include misdiagnosis or delayed diagnosis, inadequate and poorly trained manpower, absence of chemotherapeutic agents, lack of radiotherapy facilities, inadequate or inappropriate diagnostic support, and poorly developed health insurance services.
However, playing a major role in this is having to out-of-pocket for cancer treatment due to a poorly developed health insurance system.
Though the retired Army Captain could finance his treatment and also has financial backing from his children, many are, however, not that lucky as they become burdened with huge bills starting right from the registration procedure to the treatment, mainly by sourcing for funds from friends, relations, and non-governmental organisations. In a worst-case scenario, a handful resort to begging alms on the street to buy the most basic medication, which also is not cheap.
The reality is that families of those with cancer also bear the psychological and emotional brunt, especially in resource-limited settings like Nigeria, where cure rates have lagged behind and survival rates from cancer are low due to the lack of political will on the part of the government, unaffordable cost of treatment, and delayed diagnosis, among others.
It can be reversed
The elderly man, however, said the worrisome trend could be reversed through early and regular prostate cancer screening.
He said, “My father died of prostate cancer in 1963. Then 10 years later, in 1973, my father’s younger brother also died of it. In 2017, my elder brother died of prostate cancer, followed by my younger brother, the last born of the family, in 2021.
“So, I have lost four people in my family to prostate cancer. My father was not aware that he had prostate cancer. But my uncle and brothers had the symptoms but were busy taking local herbs until their condition degenerated. They were always having back pain and difficulty urinating, but by the time they agreed to go to the hospital to get appropriate treatment, it was too late.
“They were all diagnosed with advanced-stage of prostate cancer and they died in the hospital. In fact, in my younger brother’s case, the doctor said the local herbs had destroyed his liver and kidneys. He died at the age of 58 years.”
Continuing, he said, “This is why awareness is very important. Now, what can save a man from such bad news is a regular PSA test. Men should carry out prostate cancer tests at least once a year. The government should sensitise the public on prostate cancer tests.
“Regular test lead to early detection and can reduce the burden of cost and other challenges associated with prostate cancer. Men with prostate cancer and without the financial muscle to access treatment will keep urinating and defecating on their bodies, and will not survive the killer disease.
“You may be required to carry out between 15 to 20 tests before being diagnosed with prostate. The cost of the diagnosis alone is killing, let alone the treatment. “Surviving prostate cancer is tough in Nigeria due to out-of-pocket payment for treatment. I sold my house to pay my medical bills. When I exhausted all I had, my children started helping to foot my bills.”
Early screening is essential
Experts who spoke with Reportr Door Healthwise on the issue said men with a family history of prostate cancer should begin their PSA test from the age of 35, while those without a history should begin at 40.
Elaborating further on this, Prof. Yates, an internationally recognised expert in prostate cancer health disparities research, cell biology, molecular biology, and molecular pathology, said black men are twice more likely to die from prostate cancer than white.
The researcher said, “So, that is a problem and we need to address the problem. To an average man out there, if you get a prostate cancer test done annually, you can save your life. Screening is really very key.
“ No man out there should die of prostate cancer if they have their test done annually. If it is detected early, you do not have to die from the disease and can still lead a normal life. We want to have early-stage intervention; you know that late presentation involves chemotherapy and all that.
“We don’t want prostate cancer patients to get to that late stage before presenting at the hospital. We want to catch the disease early. We don’t want a late presentation.”
PSA test key to early detection
A public health physician and Permanent Secretary at Lagos State Ministry of Health, Dr. Olusegun Ogboye, said every man, who is 4o years and above should monitor their PSA.
“You should see a healthcare provider to check the size and texture of your prostate because prostate cancer is very common among men. But it is one of those cancers that when detected early, can be cured.
“We should also know the early warning symptoms. When you have any of those symptoms, go for a health check immediately. We need to key into health insurance to reduce the financial burden of access to care.
“We need to have financial protection. We are one illness away from poverty. We really have to be careful and subscribe to health insurance packages that will address our needs.”
Prostate cancer symptoms
According to him, symptoms of prostate cancer can be blood in the urine (Hematuria), painful ejaculation, and pain in the lower back, hips or upper thighs.
Dr. Ogboye also identified a dull pain in the lower pelvic area, frequent urination; trouble urinating, pain, burning, or weak urine flow as other symptoms.
“Others are loss of appetite, loss of weight and pain in the bone. In its early stages, prostate cancer often has no symptoms”, he added.
He urged men having any of the above-listed symptoms to see a doctor for a health check.
Meanwhile, in a recent article published in the Pan African Medical Journal titled, “Prevalence and characteristics of prostate cancer among participants of a community-based screening in Nigeria using serum prostate-specific antigen and digital rectal examination”, the authors said prostate cancer screening was not a common practice in Nigeria in spite of prostate cancer being the most commonly diagnosed cancer in Nigerian men.
According to them, awareness about prostate cancer is very poor.
“Majority of our patients, therefore, usually present in the hospital with the disease in the advanced stage. This community-based testing for prostate cancer, which was entirely at no financial cost for the participants, has given the opportunity to create more awareness about the disease in the community”, the authors said.
Ways forward
Collectively, the experts called for more awareness creation, education and screening for prostate cancer prevention.
For Dr. Umar, the NCS president, there is need for greater investment in the health of Nigeria’s citizens and urged the government and Nigerians to take action toward the prevention, detection and treatment of cancer.
He said unless this happens, Nigerians will continue to record disproportionate cancer deaths.
“The government must take crucial policy steps to ensure healthcare equity. With greater awareness and policy action, Nigeria will close the cancer care gap,” he advised.
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