Annals of African Medicine
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ORIGINAL ARTICLE
Year : 2010  |  Volume : 9  |  Issue : 3  |  Page : 113-117

An overview of cancer of the prostate diagnosis and management in Nigeria: The experience in a Nigerian tertiary hospital


1 Division of Urology, Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
2 Division of Urology, Department of Pathology and Morbid Anatomy, University of Ilorin Teaching Hospital, Ilorin, Nigeria

Correspondence Address:
Abdulwahab A Ajape
P.O. Box 4850, GPO, Ilorin. Kwara State, Nigeria - 240 001
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1596-3519.68353

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Objective: To review our experience with cancer of prostate management, highlighting the mode of presentation, method of diagnosis, and the treatment outcome. Methods: Medical records of patients managed for cancer of prostate were retrospectively reviewed over a 10-year period. Relevant information which included the year of diagnosis, age at presentation, mode of presentation, digital rectal examination (DRE) findings, ultrasound (USS) assessment of the prostate, the prostate-specific antigen (PSA) value, the histology report, treatment offered and the outcome were extracted. Data were analyzed with SPSS version 11 software. Results: A total of 192 patients were managed for cancer of prostate within the study period but only 90 case notes were available for analysis. There was a 7.7 fold increase in the incidence of cancer of prostate. The mean age (±SD) at presentation was 68.4 (±10.1) years with an age range of 47-91 years and the peak incidence occurred in the seventh and eighth decades of life. The mean duration of symptoms prior to presentation was 10.3 (±17.1) months. A total of 66.7% of cases presented within 6 months of the onset of symptoms as against 14.4% of cases presented after a year. Majority of cases (88.9%) presented as locally advanced or metastatic disease and only 4.4% of cases were found incidentally. Only 38.9% had histologic confirmation of the diagnosis before management was instituted. DRE gave a false negative finding in 28.6% in this study. The sensitivity and false negative value of USS was 50% each and 3.3% had PSA within normal value. Bilateral orchidectomy was offered to 64 of 90 (71.1%) and the cancer related death (CRD) was 15.6%. The maximum follow-up period was 36 months in this study and 36.9% are still attending follow-up clinic. Conclusion: There was an apparent increase in the incidence of cancer of prostate from the present study with majority still presenting with advanced disease. The sensitivity of DRE was high; this probably accounted for the treatment without establishing the histologic diagnosis in majority of the cases. Such a practice of clinical diagnosis alone should be discouraged.


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