Metabolic alterations in Africans with prostate cancer before bilateral orchidectomy

Abstract

Introduction: Prostate cancer (PCa) is the commonest male malignancy worldwide with African descent and age greater than 50 years as important risk factors. Men (75%) with PCa undergo bilateral orchidectomy (BO) as preferred mode of treatment due to late presentation. Reports show poor management outcome with rapid progression to key features of metabolic syndrome (MS) and increased mortality rate of 64% within 2 years. This study was aimed at identifying pre-existing metabolic changes in blacks with PCa before BO. Methods: 100 participant s were recruited by convenience sampling. Demographic, clinical history and life style measures were obtained from pre-test questionnaire. Anthropometric indices and blood pressure readings were obtained by standard methods. Serum testosterone and prostate specific antigen (PSA) were estimated by enzyme immunoassay. Fasting plasma glucose (FPG), total cholesterol (TC), triglycerides and high-density lipoprotein (HDLC) were determined by enzymatic methods while low density lipoprotein was calculated. pÂ0.05 was considered significant. Results: The mean PSA level in PCa group was higher than BPH and control groups. On the other hand, the mean serum testosterone levels in PCa and BPH were significantly lower than the corresponding value in the control group. 25.8%, 30.6%, 30.0% of PCa, BPH and control groups respectively had MS. Elevated BP, FPG and reduced HDLC were the most prevalent MS components while elevated WC and elevated triglyceride were the least MS components in all groups. Conclusion: Testosterone is reduced in prostatic diseases. Preexisting MS in males with PCa before BO may inform the high mortality observed after BO.