Correlation Between Bone Metastases and PSA Among Prostate Cancer Patients at Kilimanjaro Christian Medical Centre from June 2018 to May 2019

Samuel Kibona,Alfred Mteta,Jasper Mbwambo,Frank Bright,Orgeness Mbwambo,Nicholaus Ngowi,Mbarouk Mohammed

doi:10.11648/j.ijcu.20210501.20

Abstract

Prostate cancer is a leading cause of cancer death in men, second only to lung cancer. Bone metastasis is a common complication in prostate cancer patients that can cause bone pain and pathological fracture. PSA, Gleasons score, clinical T stage have been developed to integrate multiple clinical metastatic disease in prostate cancer patients. Bone radiography is used to rule out bone metastasis. It’s common to have bone metastasis when PSA level is high and histology of poorly differentiated adenocarcinoma. Aim: To determine the prevalence of osteoblastic lesions and analyze the correlation of PSA levels, on lumbar sacral radiography in patients diagnosed with prostate cancer. Methods: This was a hospital based cross-sectional retrospective study, conducted at KCMC urology institute from June 2108 to May 2019 and all prostate cancer patients diagnosed at KCMC during the study period both inpatients and outpatients attending urology department within the study period. The structural data sheet was used to collect information from patient file. Study parameters include Age, Gleason’s score, PSA level used to assess the correlation with osteoblastic lesion on lumbar sacral x-ray. Results: A total of 97 patients included in the study, with mean age was 74.5 (SD) 8.97.6 yrs. Patients with Gleason score of 8-10 were 56 (57.8%) and the median PSA level was 126ng/mL with IQR (58.9-402.2) and The prevalence of bone metastases was 57.7%. There were 56 (49.5%) patient had osteoblastic lesions on lumbar sacral x-ray with PSA >100. Conclusion: The prevalence of bone metastasis is 57.7% with 49.5% of the patients had total serum PSA of >100ng/ mL. So lumbar sacral X ray can be used as a diagnostic tool when PSA is more than 100ng/ml. There is a need to avoid unnecessary lumbar sacral X rays in patients with carcinoma of the prostate who have no symptoms and sign metastatic disease and has PSA of less than 100ng/ml.

Highlights

Prostate cancer is a leading cause of cancer death in men, second only to lung cancer [1]
Bone metastasis is a common complication in prostate cancer patients that can cause bone pain and pathological fracture
The aim of the study was done to show how the PSA correlates with the findings on lumbar sacral X ray among patients diagnosed with prostate cancer

Summary

Introduction

Prostate cancer is a leading cause of cancer death in men, second only to lung cancer [1]. Bone metastasis is a common complication in prostate cancer patients that can cause bone pain and pathological fracture. Bone is a common target of distant metastases in prostate cancer. Kidney and breast present with metastases to the bone. Prostate cancer is unique in that bone is often the only clinically detectable site of metastasis, and the resulting tumours tend to be osteoblastic (bone forming) rather than osteolytic (bone lysing). The Plain radiographs (X-rays) demonstrate characteristic osteoblastic lesions [2]

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