PROSTATE CANCER: SO MUCH VERBIAGE, SO MODEST MILEAGE?
*Urology Unit, Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt and Urology Unit, Department of Surgery, University of Calabar Teaching Hospital, Calabar.
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Background: Prostate cancer has been described as an epidemic among black men. The management from screening through diagnosis to treatment is dogged by controversies.
Aim: To articulate the areas of controversy in the management of prostate cancer.
Methods: A literature search on the internet, especially Pubmed, from 2000 to 2010 was done using the term: ‘prostate cancer, controversies in management’ to identify publications on the subject. Reference lists from these publications were also used to access the referred publications. The aspects of the management of prostate cancer that were controversial were identified and studied further,
Results: All aspects of the management of prostate cancer from screening through diagnosis and treatment revealed controversies from different authors in different countries. The natural history of the disease is variable from one patient to another and from one place to the other. Efforts are on going to identify preventive measures, principally from environmental factors. Interest in genetic factors has developed. Treatment options vary, depending on the status of the patient at presentation and what facilities are available.
Conclusion: The natural history of prostate cancer remains unknown and varies among individuals. Black men all over the world are at increased risk and have poorer prognosis compared to other racial groups. Early treatment is suspected to improve prognosis. Data from continuing research may further clarify the picture and are eagerly awaited.
Key words: Prostate cancer, Black men, Natural history, Prevention.