PDF(Pubmed)
Abstract：
BACKGROUND: Early diagnosis of prostate cancer is key to achieving a cure and its proper management leads to a good prognosis. In Ghana a large percentage of patients present with advanced disease and unusual presentations in these patients result in greater delay in the diagnosis thus worsening the outcomes.
METHODS: We present three African males with advanced prostate cancer who had delayed diagnosis. The first patient, a 64 year old male presented with ascites of 2 years duration with weight loss and no lower urinary tract symptoms, the second, a 69 year old man with end stage renal failure of 6 months duration and was receiving dialysis, the third case, an 87 year old man was managed for pulmonary tuberculosis after he presented with chronic cough and lower urinary tract symptoms. All patients eventually had a prostate specific antigen done which were elevated. Further investigations including prostate biopsies, abdominopelvic CT scans for case 1, abdominopelvic ultrasound, prostate biopsies and blood urea and electrolytes for case 2, prostate biopsies, chest and lumbosacral showed a diagnosis of metastatic prostate carcinoma, and all patients were managed with androgen deprivation. The second patient received additional radiotherapy.
CONCLUSIONS: A lack of knowledge of prostate cancer symptoms including unusual symptoms, can result in delayed diagnosis especially in regions of the world where a large number of patients present with advanced disease.
METHODS: We present three African males with advanced prostate cancer who had delayed diagnosis. The first patient, a 64 year old male presented with ascites of 2 years duration with weight loss and no lower urinary tract symptoms, the second, a 69 year old man with end stage renal failure of 6 months duration and was receiving dialysis, the third case, an 87 year old man was managed for pulmonary tuberculosis after he presented with chronic cough and lower urinary tract symptoms. All patients eventually had a prostate specific antigen done which were elevated. Further investigations including prostate biopsies, abdominopelvic CT scans for case 1, abdominopelvic ultrasound, prostate biopsies and blood urea and electrolytes for case 2, prostate biopsies, chest and lumbosacral showed a diagnosis of metastatic prostate carcinoma, and all patients were managed with androgen deprivation. The second patient received additional radiotherapy.
CONCLUSIONS: A lack of knowledge of prostate cancer symptoms including unusual symptoms, can result in delayed diagnosis especially in regions of the world where a large number of patients present with advanced disease.
摘要：
背景：前列腺癌的早期诊断是实现治愈的关键，其适当的管理导致良好的预后。在加纳，大部分患者患有晚期疾病，这些患者的异常表现会导致诊断延迟，从而使结果恶化。
方法：我们介绍了三名非洲男性晚期前列腺癌患者，他们的诊断延迟。第一个病人,一名64岁男性出现2年腹水，体重减轻，没有下尿路症状，第二个,一名69岁的终末期肾衰竭患者持续6个月，正在接受透析，第三种情况,一名87岁男子出现慢性咳嗽和下尿路症状后，接受了肺结核治疗。所有患者最终都获得了升高的前列腺特异性抗原。进一步的调查，包括前列腺活检，病例1的腹骨盆CT扫描，腹骨盆超声，病例2的前列腺活检和血液尿素和电解质，前列腺活检，胸部和腰骶部诊断为转移性前列腺癌，所有患者均接受雄激素剥夺治疗。第二名患者接受了额外的放射治疗。
结论：缺乏对前列腺癌症状（包括异常症状）的了解，可能导致延迟诊断，特别是在世界范围内大量患者患有晚期疾病的地区。
方法：我们介绍了三名非洲男性晚期前列腺癌患者，他们的诊断延迟。第一个病人,一名64岁男性出现2年腹水，体重减轻，没有下尿路症状，第二个,一名69岁的终末期肾衰竭患者持续6个月，正在接受透析，第三种情况,一名87岁男子出现慢性咳嗽和下尿路症状后，接受了肺结核治疗。所有患者最终都获得了升高的前列腺特异性抗原。进一步的调查，包括前列腺活检，病例1的腹骨盆CT扫描，腹骨盆超声，病例2的前列腺活检和血液尿素和电解质，前列腺活检，胸部和腰骶部诊断为转移性前列腺癌，所有患者均接受雄激素剥夺治疗。第二名患者接受了额外的放射治疗。
结论：缺乏对前列腺癌症状（包括异常症状）的了解，可能导致延迟诊断，特别是在世界范围内大量患者患有晚期疾病的地区。
