Cost-effectiveness of Bilateral Orchidectomy in the Treatment of Advanced Prostate Cancer

Abstract

Prostate Cancer has been known to be the commonest malignancy of the male urogenital tract. It  usually affects elderly and middle  aged men. Hormonal manipulation is usually indicated as treatment  option in locally advanced and metastatic diseases. In a developing  economy such as Nigeria, the cost  of treatment of diseases is usually a big issue. This is more so with the treatment of prostate cancer.  The  lower cost and increased convenience, with fewer side effects, makes bilateral orchidectomy a superior  option. In this article, we  compared the cost of bilateral orchidectomy with other modalities in the  treatment of advanced prostate cancer. This was a retrospective  study of nineteen (19) patients who had  bilateral orchidectomy in the year 2019. Information retrieved from their case  notes included biodata,  history and physical examination findings with results of laboratory investigations. Information on  preoperative  treatments was also documented. Informed consent was taken from patients before  surgery and post operative complications were  documented. Cost of surgery was compared with cost of  the other treatment modalities for prostate cancer. There were 19 patients with  a mean age of   66.89+8.65 years. Majority of the patients(47.4%) were in their 8^th decade of life. More than 50% of  patients had Gleason  Score of 9 and above. Anaesthesia was achieved using local infiltration with 1%  xylocaine for 90% of the patients, while others received  subarachnoid block. Post operative  complication was low. Bilateral orchidectomy for advanced prostate cancer is simple, safe and cost      effective compared to other modalities of treatment.