ABSTRACT: The research is on the analysis of prostate cancer in men living in
Adamawa state, this topic is essential to determining certain degenerative factors that
make individuals more at risk of being diagnosed with the condition. Some of these
factors include age, genes, lifestyle etc. The sample size afforded an opportunity for
data collection with the aid of questionnaires and interview techniques which
enhanced the knowledge of prostate cancer epidemiology, screening methods and
biomarkers (such as the prostate specific antigen test) of the condition. The data thus
derived were then analyzed with SPSS software which yielded the feasible output
that led to the results obtained. From the results obtained it could be seen that the age
group ranging from 60 to 64 had the highest occurrence and men who were members
of a younger age group like 50 to 54 were usually men with family history of
prostate cancer. This research was conducted with the help of Urologists, histologists
and specializing surgeons who were very learned and conversant in the field of
cancerous ailments as well as medical interventions.
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Key terms: biomarkers, Epidemiology, Urologist, Histologist, Screening
methods
Table of Content
Certification Statement …………………………………………………………………………….. ii
Approvals ……………………………………………………………………………………………….. iii
Dedication ………………………………………………………………………………………………. iv
Acknowledgement …………………………………………………………………………………….. v
Abstract ………………………………………………………………………………………………….. vi
1.0 Introduction ……………………………………………………………………………………….. 1
Aims and objectives ……………………………………………………………………………….. 1
2.0 Background and literature review ………………………………………………………… 3
2.1 About the prostate gland/Overview of cancer …………………………………. 4
2.2 Benign prostatic hyperplasia ……………………………………………………….. 5
2.3 Pathology of prostate cancer ……………………………………………………….. 9
2.4 Anatomical pathology ……………………………………………………………….. 10
2.5 Chemical pathology ………………………………………………………………….. 10
2.6 Cytogenetic pathology ……………………………………………………………….. 11
2.7 Prostate cancer and race …………………………………………………………… 12
2.8 Impact of prostate cancer…………………………………………………………… 15
3.0 Side effects of prostate cancer …………………………………………………………….. 15
3.1 Prostate cancer and impotence …………………………………………………… 15
3.2 Prostate cancer and incontinence ……………………………………………….. 16
3.3 Prostate cancer and infertility ……………………………………………………. 17
3.4 Epidemiology……………………………………………………………………………. 18
3.4.1 Global incidence of prostate cancer ……………………………. 18
3.5 Prostate cancer and diet ……………………………………………………………. 20
3.6 Prevalence of prostate cancer in Nigeria …………………………………….. 21
3.7 Risk factors of Prostate cancer …………………………………………………… 24
3.7.1 Age………………………………………………………………………….. 24
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3.7.2 Genetics …………………………………………………………………… 24
3.7.3 Geographical location ………………………………………………. 25
3.7.4 Obesity…………………………………………………………………….. 25
4.0 Detection, diagnosis, treatment of prostate cancer ………………………………. 25
4.1 Detection …………………………………………………………………………………. 25
4.2 Diagnosis …………………………………………………………………………………. 26
4.2.1 Clinical assessment …………………………………………………… 26
4.2.2 Clinical symptoms …………………………………………………….. 27
4.3 Digital Rectal exam …………………………………………………………………… 28
4.4 TURP (trans-urethral resection of the prostate) …………………………….. 28
4.4.1 Pros and cons of TURP ……………………………………………… 29
4.4.2 Pros of TURP …………………………………………………………… 29
4.4.3 Cons of TURP ………………………………………………………….. 29
4.5 Treatment ……………………………………………………………………………….. 29
5.0 Materials and methods ………………………………………………………………………. 31
5.1 The focus of the study ……………………………………………………………….. 31
5.2 Description of the study site ……………………………………………………….. 32
5.3 Materials used for data collection ……………………………………………….. 33
6.0 Results ………………………………………………………………………………………………. 35
7.0 Discussion ………………………………………………………………………………………….. 41
8.0 Conclusion/Recommendation …………………………………………………………….. 47
Reference ………………………………………………………………………………………………… 50
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List of Figures
Figure 1: Showing the prostate gland…………………………………………………………….. 6
Figure 1a: Showing an extensive view of the male reproductive system ……………. 7
Figure 2: Showing bar-chart of age against percent for incidence of prostate cancer.
……………………………………………………………………………………………………………….. 13
Figure 3: Graph showing the probability of cancer ………………………………………. 14
Figure 4: Showing the age distribution of men >40 years of age who were screened
……………………………………………………………………………………………………………….. 23
Figure 5: Showing the trends of PSA in men >40 years of age by year screening 23
Figure 6: Showing proportion of abnormal DREs to total DREs …………………….. 24
Figure 7: Showing a graph of age against severity of prostate cancer ………………. 35
Figure 8: Graph of frequency ……………………………………………………………………… 36
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List of Tables
Table 1: Showing sensitivity and specificity of different PSA thresholds ………… 14
Table 2: Showing information on a variety of treatment options and their effect on
sexual morbidity. ………………………………………………………………………………………. 18
Table 3: Attendance of men at outreach events …………………………………………….. 22
Table 4: Relationship between education and frequency of check-up ………………. 37
Table 5: Showing the ethnicity of patients in percent …………………………………….. 38
Table 7: Showing table of response of participants regarding history of prostate
cancer in the family. ………………………………………………………………………………….. 39
Table 8: Showing the symptoms experienced by participants …………………………. 40
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List of abbreviations
FMC –Federal Medical Center
Pca – Prostate cancer
DRE – Digital Rectal Exam
PSA – Prostate serum antigen test
Mm Hg – Millimetres of mercury
Bpm – Beats per minute
BPH – Benign Prostatic Hyperplasia
TURP – Transurethral resection of the prostate
1
1.0 BRIEF INTRODUCTION:
The topic of this research is one that is of keen interest and hence the reason for the
study. The topic delves into an area of the male anatomy that is of enormous
importance and one that is seemingly neglected by many academicians; especially
students. It is common knowledge that cancer is a malignant growth and replication
of cells that leads to several health complications which are mostly fatal. However,
when talking about cancer the popular ones are cervical, breast and in some cases
testicular cancer. The study of the prostate cancer and relation of it to its applications
and importance to life is one that is neglected by young academicians even though it
is a popular topic. This piqued the interest and desire to explore and research more
on this topic, in order to understand better the male anatomy and the condition itself.
AIMS AND OBJECTIVES OF RESEARCH TOPIC:
The research had specific aims and objectives that were to be accomplished in the
course of the research. These aims and objectives were the bedrock on which the
research and data collection was done. They helped to direct the format in which the
research was undergone and based on the topic the aims and objectives were as
follows:
To determine how common prostate cancer is in men living in Adamawa state:
This aspect was the main part of the research topic. It was mainly to see how many
men were living with the incidence of prostate cancer in Adamawa state. This was
done by distribution of questionnaires which made the inquiry easier. This was done
for men of ages 50 and above and majority of them had conditions relating to the
research interest. Those who did not have the cancer of the prostate had benign
2
prostatic hyperplasia and others just had mild inflammation. This aspect helped in the
identification of just how prevalent the condition was in men of Adamawa state.
Some particular age groups had fewer incidences than others and the age group with
the highest incidence was the age group ranging from 60-64.
To determine the connection between prostate cancer and genetic: This part of
the research was to determine the link if any between the prevalence of the condition
prostate cancer and genetics. The patients that were interviewed in the course of this
research shed more light on that. Prevalence of prostate cancer has been shown to be
due to several reasons and factors including genetics. The overall belief is that a man
is at a higher risk of being diagnosed with this condition if any member of his family
had had the condition prior to him. In some cases the men who had this condition had
fathers or uncles or other relatives who had had the same issue before then. However,
most of the men who were analysed did not have any such criteria or they were not
entirely sure about it. This was helpful in determining that while genetics plays a role
in the prevalence of the condition it does not play an overall role. It makes more
sense to imply that men whose family members have had the condition were in more
risk than those whose family members did not have the condition.
The impact of prostate cancer is also one of the aims of the research. This is to see
how the condition affects the patient in terms of impotency, inconsistency and
infertility. These areas are of major concern to many men and this was one of the
areas that was concentrated on to enable a vast understanding of these impacts, how
they impair the lives of the patients and how to tackle them.
The research went further to determine the risk factors related with prostate cancer.
This is because the exact cause of the condition is not known and to be able to limit
3
its prevalence the risk factors have to be understood. These risk factors were studied
based on race and ethnicity as well as lifestyle and other such factors.
Furthermore, the research was aimed at determining the effectiveness of medical
interventions and how much degree of normalcy is regained by the patient after each
procedure. This was done with the help of case studies which progressively followed
the patient from diagnoses to post-surgical conditions.
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