Living with prostate cancer can be daunting. In some cases, patients have to undergo bilateral orchiectomy (BO), the removal of testicles due to metastatic prostate cancer.
The procedure permanently reduces testosterone levels, which can help shrink tumours and alleviate symptoms like bone pain.
The Namibian spoke to two men at Windhoek Central Hospital, who recently had BO surgery.
An 80-year-old Rehoboth resident who had the surgery says he sought medical attention due to discomfort several times before his diagnosis.
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“I went more than three times to the hospital before I was diagnosed with prostate cancer last year.
“I did not know the symptoms related to prostate cancer but I am an epileptic patient and usually experienced frequent epileptic attacks,” he says.
Statistics show that prostate cancer has become the leading form of cancer in Namibia since November 2024.
Prostate cancer is sensitive to testosterone which can cause further spread.
He says his post-operation experience was normal, with pain lasting only three days, shorter than he expected.
His wife says being aware of the cancer diagnosis is better than not knowing, adding that she would support and care for her husband.
“I cannot say much, after I recover, I will see how I can adjust back to my normal life, I will have to get advice from the doctor first,” the man adds.
He has since been discharged from hospital and is recovering at home.
Another patient, a pensioner (78) from Okahandja, who was diagnosed with prostate cancer in 2012, says he has not experienced a lot of pain.
He urges fellow men to go for screening, arguing the “earlier the better”.
“We understand this operation is to prevent the further spread of cancer and I will take my medication and adhere to a lifestyle that does not risk my condition,” he says.
Windhoek-based urologist Dr Golda Stellmacher says BO is done to prevent paraplegia paralysis by preventing further cancer spread to the vertebrae. She adds that 90% of prostate cancers tend to spread to the bones. Stellmacher says age is one of the risk factors.
“The older you get, the higher your chances are to get prostate cancer. By the age of 80, about 80% of men would have developed prostate cancer if not screened and depending on lifestyle factors,” she says.
She adds that family history (genetics), race, hormones and even geography play a role in prevalence and increased risk.
“A diet high in animal fat is also a contributing factor. In areas where people consume high-fat foods, cancer risks tend to be higher,” she says.
Stellmacher adds that eating more plant-based food can reduce the risks of prostate cancer.
“For instance lycopene, a compound found in cooked tomatoes and sweet melons, has been shown to help prevent prostate cancer. If the cancer is still confined to the prostate, it can be cured,” she says.
Either the prostate is removed, or is treated through radiotherapy or brachytherapy, Stellmacher says.
She explains that each case is different depending on the stage at which the diagnosis was made.
“After diagnosis, as a team effort the urologist and oncologist meet and assess what multi-disciplinary medical environment is best for the patient. I encourage patients to go online, read, and come back with questions. I want my patients to be fully informed, before deciding what treatment option to follow,” she says.
Stellmacher says patients should not wait until they are diagnosed as it’s often too late for preventative treatment.
“We must inform the public… Sometimes there are no symptoms until the cancer is advanced. By then, it might have already spread to other parts of the body.”
Stellmacher says men with a family history of prostate cancer should begin screening from the age of 35 with prostate specific antigen (PSA) blood test and digital rectal examination (DRE) once a year.
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Those without family history should start screening from age 40, every three years for both the DRE and PSA, she adds.
From the age of 50, all men should go for check-ups every two years, Stellmacher advises.
Post-cancer treatment outcomes are done by looking at the PSA (blood tests) every three months, for two years to evaluate how effective the treatment was, she says.
“As doctors we must take our time and examine patients thoroughly, and health workers must help spread awareness,” Stellmacher says.
Fear and misconceptions remain challenges among men, she states.
“Men need to stop being afraid of the examination. Some don’t like the idea, but if they are informed, the examination will be acceptable when the digital rectal examination is performed,” she says.
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