CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Prostate cancer predominantly targets the male population and ranks as the second most prevalent cancer globally among men, following lung cancer. In 2018, there were 1,276,106 newly reported cases of prostate cancer, leading to 358,989 deaths, which constituted 3.8% of all male cancer-related fatalities (Bray et al., 2018). This form of cancer primarily affects men aged 45 to 60 and stands as a prominent cause of cancer-related mortality in Western nations (Chen et al., 2013).
The diagnosis of prostate cancer commonly involves several procedures, including prostate biopsy, prostate-specific antigen (PSA) testing, digital rectal examination, magnetic resonance imaging (MRI), or health screenings. Various risk factors are associated with prostate cancer, such as family history, ethnicity, age, obesity, and environmental factors.
Prostate cancer displays heterogeneity in both its epidemiology and genetics. The interaction between genetics, environmental influences, and social factors contributes to race-specific variations in survival rates and explains the differences observed in the epidemiology of prostate cancer across different countries (Hjelmborg et al., 2014). There is compelling evidence supporting the influence of genetics in the development of prostate cancer, and extensive research has been dedicated to investigating hereditary factors and genetic predisposition to the disease. Among the genetic risk factors, family inheritance stands out as one of the most significant contributors to prostate cancer.
Studies involving twins and epidemiological investigations have provided substantial confirmation of the involvement of hereditary factors in the development of prostate cancer (Termini et al., 2020). Researchers have delved into the potential impact of genetic variations in androgen biosynthesis and metabolism, as well as the role of androgens themselves. Through genomics research, specific molecular processes, such as chromosomal rearrangements, have been identified as contributing factors to the development of particular types of prostate cancer (Hjelmborg et al., 2014).
Gene mutations play a significant role in the development of cancer, including prostate cancer. Certain genes involved in the androgen pathway and testosterone metabolism have been identified as candidate genes for prostate cancer predisposition. The androgen receptor signaling pathway and testosterone are crucial for the growth of prostate epithelium and prostate cancer cells (Bluemn and Nelson, 2012). Identifying cancer biomarkers and targeting specific genetic mutations can enable targeted treatments for prostate cancer. Examples of biomarkers that can be used for targeted treatment include DNA tumor biomarkers, DNA biomarkers, and general biomarkers (Ziaran et al., 2015).
Prostate cancer can be categorized as either responsive to androgen hormones (androgen-sensitive) or unresponsive (androgen-insensitive), which influences the treatment options available for the disease based on its sensitivity to testosterone stimulation (Takayama, 2019). Treatment choices for prostate cancer encompass a range of approaches, including active surveillance, chemotherapy, radiation therapy, hormonal therapy, surgery, and cryotherapy. The selection of a specific treatment modality depends on several factors, such as the characteristics of the tumor, PSA (prostate-specific antigen) level, cancer grade and stage, and the likelihood of recurrence.
For instance, in cases of low-risk prostate cancer, a combination of radical prostatectomy, a surgical procedure involving the removal of the prostate and surrounding tissues, and radiation therapy may be employed (Bach et al., 2014). Androgen-deprivation therapy, also referred to as hormonal therapy, is recommended for the treatment of prostate cancers that have extended beyond the prostate or have experienced recurrence (Chen et al., 2013).
Each treatment option is associated with significant side effects, including toxicity, reduced white and red blood cell counts, fatigue, hair loss, peripheral neuropathy, erectile incontinence and dysfunction, metastasis, and the development of resistance to initial treatment. Furthermore, available treatment options are costly and can have severe adverse effects (Termini et al., 2020).
Understanding the impact of therapy choices on survival outcomes is essential for healthcare professionals and policymakers in improving patient care and treatment strategies. This study focuses on exploring the impact of the choice of therapy on the survival outcome of patients with prostate cancer in selected cancer patients at the University of Uyo Teaching Hospital.
1.2 Statement of the Problem
Prostate cancer is a significant contributor to cancer-related mortality in men worldwide. Despite advancements in treatment options, there is still uncertainty regarding the optimal choice of therapy and its impact on the survival outcomes of patients with prostate cancer. The decision-making process for prostate cancer treatment is multifaceted, considering variables such as cancer stage, aggressiveness, patient preferences, and potential treatment side effects.
Therefore, it is imperative to conduct research that specifically examines the influence of different therapy choices on the survival outcomes of patients. This research would provide valuable insights to healthcare providers and patients, assisting them in making well-informed decisions regarding the selection of appropriate treatment options.
1.3 Aim of the Study
The aim of this study is to investigate the impact of the choice of therapy on the survival outcome of patients with prostate cancer in the University of Uyo Teaching Hospital.
1.4 Objectives of the Study
The specific objectives of this study are as follows:
- To assess the different treatment options available for patients with prostate cancer in the University of Uyo Teaching Hospital.
- To determine the factors influencing the choice of therapy for prostate cancer patients.
- To examine the survival outcomes of patients based on their choice of therapy.
- To identify any significant associations between specific therapies and survival outcomes.
- To provide recommendations for optimizing therapy choices and improving survival outcomes in patients with prostate cancer.
1.5 Research Questions
To achieve the objectives of this study, the following research questions will be addressed:
- What are the treatment options available for patients with prostate cancer in the University of Uyo Teaching Hospital?
- What factors influence the choice of therapy for prostate cancer patients in the hospital?
- How do different therapies impact the survival outcomes of patients with prostate cancer?
- Are there any significant associations between specific therapies and survival outcomes in patients with prostate cancer?
1.6 Research Hypothesis
H0: The choice of therapy does not significantly impact the survival outcome of patients with prostate cancer in the University of Uyo Teaching Hospital
H1: The choice of therapy significantly impacts the survival outcome of patients with prostate cancer in the University of Uyo Teaching Hospital
1.7 Justification of the study
This study is significant because it addresses an important gap in the understanding of how the choice of therapy affects the survival outcome of patients with prostate cancer. The findings can provide valuable insights for healthcare professionals, patients, and policymakers in making informed treatment decisions and improving patient outcomes. Additionally, the study contributes to the existing literature on prostate cancer treatment and adds to the body of knowledge in this field.
1.8 Scope of the Study
This study focuses specifically on the impact of the choice of therapy on the survival outcome of patients with prostate cancer in the University of Uyo Teaching Hospital. The research will involve collecting primary data through patient interviews, medical records review, and survival outcome assessments.
