Background: Prostate cancer is the second most frequent cancer in men after lung cancer, it accounts for 3.8% of all deaths caused by cancer in men worldwide. This study aimed at determining the prevalence, grades and management of prostate cancer among male patients admitted with cancer at Oncology Department of Bugando Medical Centre. Methodology: This was a hospital-based retrospective cross-section study that retrieved data from 384 medical files of male patients admitted with cancer in Oncology wards at Bugando Medical Centre from January 2017 to December 2020. Results: The prevalence of prostate cancer was 39.84% (153 of 384 male patients). The mean age of patients with prostate cancer was 64.85 years ± 14.59 years. Two third of the patients’ prostate cancer were graded at presentation and of these, 52.58% (51 of 97) were having a high grade prostate cancer of Gleason scores 8, 9 or 10. Treatment involved hormonal therapy, chemotherapy and Radiotherapy whereby 49.48% (n = 190) were treated with hormonal therapy (Goserelin and Bicalutamide), 32.03% (n = 123) with combination of hormonal and chemotherapy, (Goserelin, bicalutamide and docetaxel or paclitaxel), 15.69% (n = 60) with combination of radiotherapy and hormonal therapy and 2.6% (n = 11) with chemotherapy alone (Docetaxel). Conclusion: The study found high prevalence of prostate cancer among male patients, majority with high grade form and limited options of treatment. Frequent screening and awareness programs should be conducted to enable early detection to reduce its morbidity and mortality. Patient on treatment should be followed up to determine their response to treatments.
References
[1]
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R.L., Torre, L.A. and Jemal, A. (2018) Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 68, 394-424. https://doi.org/10.3322/caac.21492
[2]
Center, M.M., Jemal, A., Lortet-Tieulent, J., Ward, E., Ferlay, J., Brawley, O., et al. (2012) International Variation in Prostate Cancer Incidence and Mortality Rates. European Urology, 61, 1079-1092. https://doi.org/10.1016/j.eururo.2012.02.054
[3]
Chu, L.W., Ritchey, J., Devesa, S.S., Quraishi, S.M., Zhang, H. and Hsing, A.W. (2011) Prostate Cancer Incidence Rates in Africa. Prostate Cancer, 2011, Article ID: 947870. https://doi.org/10.1155/2011/947870
[4]
Lyimo, E.P., Rumisha, S.F., Mremi, I.R., Mangu, C.D., Kishamawe, C., Chiduo, M.G., et al. (2020) Cancer Mortality Patterns in Tanzania: A Retrospective Hospital-Based Study, 2006-2015. JCO Global Oncology, 6, 224-232.
https://doi.org/10.1200/JGO.19.00270
[5]
Giovannucci, E., Liu, Y., Platz, E.A., Stampfer, M.J. and Willett, W.C. (2007) Risk Factors for Prostate Cancer Incidence and Progression in the Health Professionals Follow-Up Study. International Journal of Cancer, 121, 1571-1578.
https://doi.org/10.1002/ijc.22788
[6]
Bremner, K.E., Chong, C.A., Tomlinson, G., Alibhai, S.M. and Krahn, M.D. (2007) A Review and Meta-Analysis of Prostate Cancer Utilities. Medical Decision Making, 27, 288-298. https://doi.org/10.1177/0272989X07300604
[7]
Alcaraz, A., Hammerer, P., Tubaro, A., Schröder, F.H. and Castro, R. (2009) Is There Evidence of a Relationship between Benign Prostatic Hyperplasia and Prostate Cancer? Findings of a Literature Review. European Urology, 55, 864-875.
https://doi.org/10.1016/j.eururo.2008.11.011
[8]
Woodrum, D.L., Brawer, M.K., Partin, A.W., Catalona, W.J. and Southwick, P.C. (1998) Interpretation of Free Prostate Specific Antigen Clinical Research Studies for the Detection of Prostate Cancer. Journal of Urology, 159, 5-12.
https://doi.org/10.1016/S0022-5347(01)63996-X
[9]
Thompson, I., Thrasher, J.B., Aus, G., Burnett, A.L., Canby-Hagino, E.D., Cookson, M.S., et al. (2007) Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update. Journal of Urology, 177, 2106-2131.
https://doi.org/10.1016/j.juro.2007.03.003
[10]
Sanda, M.G., Chen, R.C., Crispino, T., Freedland, S., Nelson, M., Reston, J., et al. (2018) Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline. Journal of Urology, 199, 683-690.
[11]
Massawe, D.R. (2020) Early Outcome of Surgical Castration among Patients with Prostate Cancer at Benjamin Mkapa Hospital in Dodoma Region, Tanzania.
[12]
Taitt, H.E. (2018) Global Trends and Prostate Cancer: A Review of Incidence, Detection, and Mortality as Influenced by Race, Ethnicity, and Geographic Location. American Journal of Men’s Health, 12, 1807-1823.
https://doi.org/10.1177/1557988318798279
[13]
Mawalla, I.H., Nyamuryekunge, M.K., Ali, A., Njau, A., Adebayo, P. and Zehri, A.A. (2021) Prevalence of Incidental Prostate Carcinoma among Patients Undergoing Turp for Benign Prostatic Enlargement. Tanzania Medical Journal, 32, 13-27.
[14]
Mazigo, H.D., Zinga, M., Heukelbach, J. and Rambau, P. (2010) Case Series of Adenocarcinoma of the Prostate Associated with Schistosoma haematobium Infection in Tanzania. Journal of Global Infectious Diseases, 2, 307-309.
https://doi.org/10.4103/0974-777X.68540
[15]
Gunda, D., Kido, I., Kilonzo, S., Nkandala, I., Igenge, J. and Mpondo, B. (2018) Prevalence and Associated Factors of Incidentally Diagnosed Prostatic Carcinoma among Patients Who Had Transurethral Prostatectomy in Tanzania: A Retrospective Study. Ethiopian Journal of Health Sciences, 28, 11-18.
https://doi.org/10.4314/ejhs.v28i1.3
[16]
Parkin, D.M., Bray, F., Ferlay, J. and Jemal, A. (2014) Cancer in Africa 2012. Cancer Epidemiology, Biomarkers & Prevention, 23, 953-966.
https://doi.org/10.1158/1055-9965.EPI-14-0281
[17]
Ben-Shlomo, Y., Evans, S., Ibrahim, F., Patel, B., Anson, K., Chinegwundoh, F., Corbishley, C., Dorling, D., Thomas, B., Gillatt, D. and Kirby, R. (2008) The Risk of Prostate Cancer amongst Black Men in the United Kingdom: The PROCESS Cohort Study. European Urology, 53, 99-105. https://doi.org/10.1016/j.eururo.2007.02.047
[18]
Smith-Palmer, J., Takizawa, C. and Valentine, W. (2019) Literature Review of the Burden of Prostate Cancer in Germany, France, the United Kingdom and Canada. BMC Urology, 19, Article No. 19. https://doi.org/10.1186/s12894-019-0448-6
[19]
Thompson, I.M., Pauler, D.K., Goodman, P.J., Tangen, C.M., Lucia, M.S., Parnes, H.L., Minasian, L.M., Ford, L.G., Lippman, S.M., Crawford, E.D. and Crowley, J.J. (2004) Prevalence of Prostate Cancer among Men with a Prostate-Specific Antigen Level≤ 4.0 ng per Milliliter. The New England Journal of Medicine, 350, 2239-2246.
https://doi.org/10.1056/NEJMoa031918
[20]
Zlotta, A.R., Egawa, S., Pushkar, D., Govorov, A., Kimura, T., Kido, M., Takahashi, H., Kuk, C., Kovylina, M., Aldaoud, N. and Fleshner, N. (2013) Prevalence of Prostate Cancer on Autopsy: Cross-Sectional Study on Unscreened Caucasian and Asian Men. Journal of the National Cancer Institute, 105, 1050-1058.
https://doi.org/10.1093/jnci/djt151
[21]
Jones, J.S., Follis, H.W. and Johnson, J.R. (2009) Probability of Finding T1a and T1b (Incidental) Prostate Cancer during TURP Has Decreased in the PSA Era. Prostate Cancer and Prostatic Diseases, 12, 57-60. https://doi.org/10.1038/pcan.2008.14
[22]
Perera, M., Lawrentschuk, N., Perera, N., Bolton, D. and Clouston, D. (2016) Incidental Prostate Cancer in Transurethral Resection of Prostate Specimens in Men Aged up to 65 Years. Prostate International, 4, 11-14.
https://doi.org/10.1016/j.prnil.2015.10.016
[23]
Rugwizangoga, B. (2013) Comparison and Correlation of ki67 Expression and Gleason Score in Prediction of Biological Behaviour of Prostatic Adenocarcinoma in Tanzanian Patients. Doctoral Dissertation, Muhimbili University of Health and Allied Sciences, Dar es Salaam.
[24]
Mwakyoma, H.A. and Magandi, J.L. (2010) Prostate Cancer: Correlation of Gleason’s Score and Pretreatment Prostate Specific Antigen in Patients. The Professional Medical Journal, 17, 235-240. https://doi.org/10.29309/TPMJ/2010.17.02.2351
[25]
Tindall, E.A., Monare, L.R., Petersen, D.C., Van Zyl, S., Hardie, R.A., Segone, A.M., Venter, P.A., Bornman, M.R. and Hayes, V.M. (2014) Clinical Presentation of Prostate Cancer in Black South Africans. The Prostate, 74, 880-891.
https://doi.org/10.1002/pros.22806
[26]
Urassa, D.P., Mwangu, M. and Makwi, J.K. (2013) Utilization of Standard Treatment Guidelines (STG) at Primary Health Facilities, Magu District, Tanzania. East African Journal of Public Health, 10, 238-245.
[27]
Mwashambwa, M.Y., Lilungulu, A.G., Meremo, A.J., McCann, M. and Gesase, A.P. (2015) Retrospective Review of Clinical and Pathological Pattern of Prostatic Diseases: A Reminder to Clinicians on an Increased Clinical Vigilance, an Experience from Central, Tanzania. Tanzania Medical Journal, 27, 70-82.
[28]
Ministry of Health, Community Development, Gender, Elderly and Children (2021) Standard Treatment Guidelines and the National Essential Medicine List for Tanzania Mainland. 6th Edition, 618 p.
[29]
Francis, S. and Nyongole, O.V. (2020) What Is Known about Prostate Cancer? Response from Men Aged 50 Years and above in Lindi Municipal, Tanzania. Tanzania Medical Journal, 31, 33-44. https://doi.org/10.4314/tmj.v31i2.363
[30]
Ferlay, J., Colombet, M., Soerjomataram, I., Parkin, D.M., Piñeros, M., Znaor, A. and Bray, F. (2021) Cancer Statistics for the Year 2020: An Overview. International Journal of Cancer, 149, 778-789. https://doi.org/10.1002/ijc.33588