Modes of Presentation of Patients with Suspected Prostate Cancer Disease in Two Nigerian Semi-Urban Referral Health Facilities

Background: Prostate cancer is the most commonly diagnosed cancer in men and the second leading cause of cancer mortality after lung cancer worldwide. The incidence of this disease is high among men of African descent. The modes of presentation of patients with prostate cancer are varied. In this paper, we present an overview of the modes of clinical presentation of men with suspected prostate cancer and their relationship with the histological diagnosis of prostate cancer.

Materials and Methods: This was a prospective and hospital‑based study. Patients who had a prostate biopsy done due to elevated serum prostate‑specific antigen (PSA) levels, abnormal digital rectal examination (DRE) findings of the prostate gland, or a combination of both were included in this study. Their biodata, modes of presentation, and other clinical and histological information were recorded in a pro forma. Data analysis was done using the statistical programming for social sciences (SPSS) version 21. For all statistical tests, P < 0.05 was regarded as significant.

Results: One hundred and thirty-two patients were recruited into this study. The mean age of the patients was 69.75 ± 9.15 years. Most participants (75%) were in their seventh and eighth decades of life. The mean serum PSA level was 35.01±8.52ng/ml (range: 6 to 164ng/ml), while the mean prostate volume was 101.4 ± 91.4 ml (range: 10–635ml).

Lower urinary tract symptoms (LUTS) were the most common mode of presentation accounting for 97.7% (n=129) of the cases studied. This was followed by haematuria (34.1%, n=45), low back pain (25.8%, n=34), weight loss (22.7%, n=30), and paraplegia/paraparesis (7.6%, n=10). Bone pains and paraparesis/paraplegia significantly correlated with the diagnosis of adenocarcinoma of the prostate.

Conclusion: The majority of men with suspected prostate cancer were found to be symptomatic at presentation. The modes of presentation were varied with LUTS being the most common. Low back pain and paraparesis/paraplegia were positive predictors of prostate cancer disease.