Burden of prostate cancer in southwestern Nigeria.
OBJECTIVE
To determine the pattern of presentation, prevalent age, hospital incidence, and outcome of management of prostate cancer in our environment.


METHODS
Patients with histopathology evidence of prostate cancer managed between January 1991 and December 2007 were studied. Information entered into a pro-forma sheet and analyzed included the age of patients, clinical features, investigations, histopathology diagnosis, outcome of management, and duration of follow-up.


RESULTS
During the period, 189 patients aged 46-99 years (mean, 68.0; 9.8 SD) confirmed and managed for prostate cancer were studied. The average hospital incidence (2002-2004) was 182.5 per 10(5) male admissions with 15.1-month mean duration of symptoms. Most 178 (94.2%) patients presented with advanced diseases, with 1 or multiple complications in 172 (91.0%), obstructive lower urinary tract symptoms 156 (82.5%), distant metastasis 97 (51.3%), lower back pain 95 (50.3%), weight loss 95 (50.3%), hematuria 86 (45.5%), anemia 77 (40.7%), renal failure 74 (39.2%), and inability to walk 42 (22.2%). Eighty-nine (47.0%) patients were farmers, 111 (58.7%) indulged in alcohol, and 46 (24.3%) smoked cigarettes. Mean prostate-specific antigen results available in 53 patients was 106.0 ng/mL (187.2SD) and digital rectal examination was valuable in diagnosis. Adenocarcinoma (186 [98.4%]) was the main histopathology type and most patients 136 (71.9%) had bilateral orchidectomy with or without antiandrogens. Mean duration of follow-up was 83.7 weeks.


CONCLUSIONS
The burden of prostate cancer in our developing community is worrisome. It is prevalent between 46 and 99 years in our community. Presentation is late, often with urinary retention and other complications. In our setting, treatment is still essentially palliative with orchidectomy, which we found to be beneficial, acceptable, and the most affordable to our patients.
Badmus
Tajudeen A
TA
Department of Surgery; Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University; and Obafemi Awolowo University Teaching Hospital, Complex, Ile-Ife, Nigeria. akintab@yahoo.com
Adesunkanmi
Abdul-Rasheed K
AR
Yusuf
Babatunde M
BM
Oseni
Ganiyu O
GO
Eziyi
Amogu K
AK
Bakare
Tajudeen I B
TI
Adetiloye
James A
JA
Badmus
Sarat A
SA
D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011471:Prostatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies