Management of Prostate Cancer in Port Harcourt, Nigeria: Changing Patterns

Background: This is a follow up to a study done at the University of Port Harcourt Teaching Hospital (UPTH) 11 years ago on the management of prostate cancer.

Aims: To assess the current pattern in the management of prostate cancer in Port Harcourt, Nigeria and the impact of changes in diagnosis and treatment.

Methods: All the case notes of prostate cancer presenting in the University of Port Harcourt Teaching Hospital between January 2003 and December 2012 were reviewed. Data on demography, clinical presentations, co-morbidities, investigations, treatment, complications and outcome of treatment were extracted and analyzed using SPSS 20.0 0 RESULTS: A total of 294 histologically confirmed patients with cancer of the prostate were treated within the study period. Out of these, 216 (73.5%) case notes were analysed. The mean age was 69.9 years (51 -90 years). All the patients had lower urinary tract symptoms, 30 (14.0%) had haematuria while 19(8.8%) presented with paraplegia. The prostate specific antigen (PSA) ranged from 0.5 - 760ng/ml. Two hundred and five (95%) received androgen deprivation therapy. Of these, 123 (60%) had bilateral subcapsular orchidectomy and anti androgen, 3 (1.4%) had abiraterone. Five (2.3%) had radical prostatectomy, 22 (10.2%) had chemotherapy while 16(7.4%) had radiotherapy. Seventy-two (33.5%) died within 2 years of diagnosis while 49(30.2%) survived more than 5 years.

Conclusion: There is rising prevalence of carcinoma of the prostate in this centre. Many patients presented late. There has been expansion in diagnostic and therapeutic capabilities with attendant improvement in patients' survival. Co-morbidities adversely affected the outcome of treatment.