Prostate cancer - experience from a specialist urological facility in Sri Lanka

Abstract

Objective: Prostate  cancer(CaP)  is  one of  the  a  commonest  malignancies  in  the  aging  male. Data on this aspect is sparse in Sri Lanka. Following  a initial report, we present 4½  year  review with regard  to  the mode of presentation, stage  and  histological  characteristics & therapeutic options for CaP.

Methods: This is a prospective cohort study of 236 CaP patients presented to a specialist urology unit  from 2007 up to May 2012.

Results: Out  of 236 CaP diagnosed, mean age was 70.23.The peak incidence was in the age group 71-75 with 75% of patients being diagnosed at this age interval. LUTS(52.5%), Retention of urine(33.5%) & backpain(31%)  were the  commonest presentations. 51% patients had their initial PSA level above 40ng/ml & only  10% were PSA “non secretors”.

Majority of patients (56.4%) had Gleasons 7 or higher histological patterns and 77% had advanced disease at  presentation.

Androgen ablation therapy was the commonest treatment modality 63%(n=148) used. Out of them a majority of  90%(n=134) underwent bilateral orchidectomy. Only 15.4%(n=36) were suitable for treatment with a curative intent, 9% were treated with radical radiotherapy while 6.4% underwent radical prostatectomy. 17%(n=41) of the patients required a treatment with  combination of above therapies.

Conclusions: This study highlights the need  of  higher  awareness  amongst  men  beyond  50  years  regarding prostate  cancer  and  development  of  a  protocol  based  strategy  to  handle  CaP which is  likely  to  be  significant  health  care  burden  in  an  increasingly  aging  population  in Sri  Lanka.