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Cancer Of The Prostate: Experience At Nnewi, Southeast, Nigeria
Abstract
Objective: To evaluate the clinical presentation, method of diagnosis, treatment and outcome of prostate cancer patients.
Patients and Methods: A 5-year retrospective study of all patients seen with the diagnosis of cancer of the prostate at the Urology Unit of Nnamdi Azikiwe University Teaching Hospital, Nnewi from January1, 1996 to December 31, 2000. The demographic pattern, clinical features, laboratory findings, treatment modalities and outcome were studied.
Results: A total of 54 cases were seen. Cancer of the prostate was the commonest urological tumour accounting for 77.1%. There was a 4-fold increase in annual incidence between 1996 and 2000. Mean age was 71.0+10.9 years with a range of 44-92 years. Average duration of symptoms before presentation was 8 months while the commonest mode of presentation was Lower Urinary Tract Symptoms (LUTS). Digital Rectal Examination (DRE) had a predictive value of 66.7%. PSA was obtained only in 17 patients. Values of < 4ng/ml was obtained in 11.7%, values between 4-10ng/ml in35.2%, between 10-20ng/ml 5.8% while 47.1% had values above 20ng/ml. Biopsy obtained in 14 patients showed poorly differentiated adenocarcinoma in 78.6%, well differentiated adenocarcinoma in 7.1% while 14.3% were unclassified. Commonest mode of treatment was bilateral orchidectomy in 46.3%. Follow up was variable from 3months to 6 years. Mortality was 22.2% while 33.3% were lost to follow up.
Conclusion: Prostate cancer is a major problem facing the aging male. Inadequate facilities make early detection difficult. Treatment is mainly palliative because of late presentation.
Key Words: Prostate cancer, Incidence, Presentation, Diagnosis, Palliation.
Nigerian Journal of Clinical Practice Vol. 7(2) 2004: 65-68
Patients and Methods: A 5-year retrospective study of all patients seen with the diagnosis of cancer of the prostate at the Urology Unit of Nnamdi Azikiwe University Teaching Hospital, Nnewi from January1, 1996 to December 31, 2000. The demographic pattern, clinical features, laboratory findings, treatment modalities and outcome were studied.
Results: A total of 54 cases were seen. Cancer of the prostate was the commonest urological tumour accounting for 77.1%. There was a 4-fold increase in annual incidence between 1996 and 2000. Mean age was 71.0+10.9 years with a range of 44-92 years. Average duration of symptoms before presentation was 8 months while the commonest mode of presentation was Lower Urinary Tract Symptoms (LUTS). Digital Rectal Examination (DRE) had a predictive value of 66.7%. PSA was obtained only in 17 patients. Values of < 4ng/ml was obtained in 11.7%, values between 4-10ng/ml in35.2%, between 10-20ng/ml 5.8% while 47.1% had values above 20ng/ml. Biopsy obtained in 14 patients showed poorly differentiated adenocarcinoma in 78.6%, well differentiated adenocarcinoma in 7.1% while 14.3% were unclassified. Commonest mode of treatment was bilateral orchidectomy in 46.3%. Follow up was variable from 3months to 6 years. Mortality was 22.2% while 33.3% were lost to follow up.
Conclusion: Prostate cancer is a major problem facing the aging male. Inadequate facilities make early detection difficult. Treatment is mainly palliative because of late presentation.
Key Words: Prostate cancer, Incidence, Presentation, Diagnosis, Palliation.
Nigerian Journal of Clinical Practice Vol. 7(2) 2004: 65-68
