The incidence, presentation and management of prostatic cancer - abstract

ABSTRACT

Twenty-nine patients were seen for the first time with prostatic cancer over a 12-month period in the Urological Unit, Georgetown Hospital, Guyana. Twenty-five were Afro- or mainly Afro-Guyanese and four were Indo-Guyanese. The ages ranged from 54 to 88 years. The 70 to 80-year-old group was most commonly affected. Patients presented with painful dysuria, acure retention of urine, haematuria, back pain or a combination of these features. Rectal examination confirmed the diagnosis in all but one case. The prostate felt hard and fixed with evidence of infiltration. Haemoglobin levels tended to be low. Serum acid phosphatase levels were not always increased. The plain X-Ray film supplied useful confirmatory evidence in the presence of osteoblastic/osteolytic metastases in the absence of prostatic calculi in the palpably "hard" prostate. Bougienage for purposes of catheter introduction in the acutely distended bladder is of great diagnostic value if the prostate is grotty to the feel. Most patients were managed with low-dosage oestrogens. Some required Per Urethro-electro-resection (PUER) of the prostate in addition to stilboestrol therapy (AU)