Prostate cancer case finding in patients with lower urinary tract symptoms in a private hospital in Dar-Es-Salaam

Abstract

Objective: To determine the proportion of patients with Carcinoma of the Prostate in patients presenting with Lower Urinary Tract Symptoms.

Methods: This was a four years prospective case finding study of patients aged 50 years and above with Lower Urinary Tract Symptoms (LUTS) in a private hospital in Dar-Es Salaam. Investigations included renal function tests, Prostate Specific Antigen (PSA) and prostatic biopsy.

Results: Of the 201 consecutive patients with LUTS, 86.1% had BPH while 13.9% had Prostate Carcinoma (CP) with an average PSA of 51.99 ng/ ml. Digital rectal examination (DRE) was abnormal in 23 cancer patients. In 2 patients diagnosis followed finding a raised PSA. In 3 patients carcinoma was an incidental finding following TURP. Treatment consisted of orchidectomy in 24 patients, Lutenizing Hormone Releasing Hormone (LHRH) agonist (Zoladex) in two while one patient received radiotherapy. Two of the patients who had incidental CP finding with low Gleason score were on watchful waiting.

Conclusion: Case finding rather than community screening for prostate cancer is preferred due to economic reasons. PSA when available is a useful additional investigation. Efforts should be made to detect the disease early as the urologists in the region arm themselves ready for the challenge of radical prostatectomy.