Assessing the Level of Prostate Cancer Care in a Low-Resource Setting: Disease Pattern, Current Situation of Care,...

Prostate cancer (PC) is a common male malignancy, and it is often diagnosed at advanced stages, particularly in developing countries, largely due to underdeveloped healthcare systems. Resource-limited care, such as bilateral orchidectomy for symptomatic illness, is an economically feasible therapeutic option that may enhance patient condition and survival in a low-resource situation. This study aims to assess the status of PC care and treatment outcomes in eastern Sudan.

A retrospective hospital-based study was conducted at the East Oncology Centre (EOC), Gadarif State, eastern Sudan, including all patients diagnosed with PC between May 2016 and December 2023. Relevant demographic, clinical, pathological, treatment, and outcome data were retrieved from patients' medical records.

A total of 231 patients with PC, with a mean age of 70.9 years (± SD 10), all of whom were Sudanese from different ethnic groups, were included in the study. Most patients (86.6%; n = 200) presented with lower urinary tract symptoms, and only 15.6% had a family history of PC. Most of the patients (62.34%, n = 144) had prostate-specific antigen (PSA) levels ranging from 21 to 100 ng/mL; histopathology revealed adenocarcinoma of the prostate with a Gleason score of 8 or more in 60.6% (n = 140). Bone scan results were positive in 50.2% of cases, and 88.3% (n = 204) received hormonal treatment as the primary modality for cancer control. The mortality data indicate that 24.7% (n = 57) of patients had died.

This study highlights the suboptimal care for PC in eastern Sudan, where most patients present with late-stage disease, probably due to resource limitations. Addressing late-stage PC requires opportunistic digital rectal examination screening, targeted PSA testing, and increased awareness. Improved outcomes rely on specialist training, standardised care protocols, and the expansion of radiation facilities.