Adenocarcinoma of the Prostate in Young Patients: Management and Outcomes in a Urology Center in Douala Cameroon

Abstract

Background: Prostate cancer which is the second most frequent cancer diagnosis made in men, more commonly occurs in the elderly. However, it sometimes occurs in younger men, especially in those with a family history of the condition. This study aimed to determine the characteristics of prostate cancer in younger adults and identify the determinants of the early screening and diagnosis of this pathology. Methods: We performed a retrospective study from 2012 to 2016 at the Centre medico-chirugical durologie in Douala Cameroon in which we included 29 patients aged 60 years or less who had prostate cancer diagnosed via histopathology after either prostate biopsy or palliative endoscopic prostate resection. Epi-info 7 was used for data analysis and the Kaplan-Meier curve was used to estimate the overall survival of the study participants. Results: The mean age of our study participants was 50.66 ± 5.31 years. Nine patients had a contributive family history of prostate cancer. Seventeen patients had metastases, with ten having bone metastases and thirteen having lymph node metastases. As initial therapy nine patients underwent laparoscopic total radical prostatectomy seven underwent medical Androgen Deprivation Therapy (ADT), ten underwent surgical ADT (bilateral pulpectomy), two underwent radiotherapy and one underwent active surveillance. Four patients underwent secondary treatment with two of them undergoing chemotherapy one undergoing ADT and one undergoing radiotherapy. Tumor recurrence occurred in seven patients. The rate of tumor recurrence was significantly higher among patients with a contributive family history. Six patients died in this study and the five-year overall survival of our study participants was 80%. Conclusion: Prostate cancer is a major public health issue not only in the elderly but also in younger men. Screening for this condition could be performed in younger patients too especially those with a contributive family history to ensure early diagnosis and reduce the morbidity and mortality associated with the condition. Keywords: Prostate cancer; Young patients; Prostate biopsy; Palliative treatment