Prostate Cancer and Challenges in Management in a Semi-urban Centre: A 10-year Experience.

Abstract

Prostate cancer (CaP) is the second most common cancer in men and the fifth most common cancer worldwide. The incidence in Nigeria is rising. Numerous challenges exist that prevent the successful management of these patients in this subregion. This study aimed to report on the modes of presentation and difficulties encountered in managing patients with CaP in our environment with a view to finding solutions to these challenges. This was a retrospective study of all CaP patients who were managed in Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria over a 10-year period from 2012 to 2021. Data were collated using a pro forma. Numerical data were summarized as means, median, and standard deviation, whereas categorical data were summarized as frequencies. Statistical significance was pegged at P < 0.05. Seventy-three patients were analysed. The mean age of the patients was 71.48 ± 8.15 years. The three most common presenting complaints were lower urinary tract symptoms (LUTSs) 23 (31.5%), acute urinary retention 9 (12.3%), and LUTS with low back pain 9 (12.3%). The median duration of symptoms was 6.5 months. No difference was noted among educational level, occupation, and stage of CaP, (P=0.222 and P=0.548), respectively. The median total prostate-specific antigen was 85.0 ng/mL. Sixty-seven patients (91.8%) had an abdominopelvic ultrasound scan. Fifty patients (68.5%) had stage 4 disease. Thirty-eight (52.1%) had financial constraints. Forty-nine (67.1%) patients were lost to follow-up. Bilateral orchidectomy was offered to 28 (38.4%) patients. Financial constraint was a huge barrier in the management of CaP patients in this study. Late presentation was common in this study.