Management of prostate cancer in Senegal: What is being done?

Objective: To evaluate the management of patients with prostate cancer in Senegal. Materials and methods: We performed a retrospective descriptive study, based on the medical records of patients managed for prostate cancer during a period of six years and a half from January 1, 2004, to June 30, 2010. All records of inpatients and outpatients managed for prostate cancer were collected. Data collection was performed through a standardized survey form, and included the following parameters: age, presence or absence of known history of prostate cancer in siblings, circumstances of discovery, clinical and paraclinical examination, histology and therapeutic modalities. Results: We studied the records of 164 patients with prostate cancer. The mean age of our patients was 65. years, ranging from 43 to 96. years. The circumstances of diagnosis were mostly due to lower urinary tract symptoms. Digital rectal examination was suggestive in 87% of cases, and PSA levels were high in 100% of cases, ranging from 5.88. ng/ml to 21,660. ng/ml, with a mean of 1447.57. ng/ml. Half of the patients had PSA levels greater than or equal to 100. ng/ml. The most common histological type was adenocarcinoma. During the study period, 49 radical prostatectomies were performed. The mean PSA levels of patients who underwent a prostatectomy were 23.4. ng/ml. Radical retropubic prostatectomy was performed in 35 patients, and radical perineal prostatectomy was performed in 10 cases. Pulpectomy was the method most commonly used in metastatic prostate cancer; it was performed in 48 patients. After resistance to castration, antiandrogens were reintroduced in 13 patients, and diethylstilbestrol in four patients. Only two patients underwent a taxane-based chemotherapy regimen. Conclusion: The diagnosis of prostate cancer was usually tardive in Senegal. Treatment often involves surgical castration. Prostatectomy was only very seldom indicated. © 2012 Elsevier Masson SAS.