Analysis of prostate cancer in Tamil Nadu and Pondicherry: Are we missing the boat?

OBJECTIVES: Why is it that we do not see enough early prostate cancer in our urological practice? Is it really uncommon, or is it that we are not convinced about the need for its aggressive management? This study intended to look at the opinion and patterns of practice among urologists in Tamil Nadu and Pondicherry, with regards to early prostate cancer. MATERIALS AND METHODS: A questionnaire was sent to 63 urologists of these states to assess their opinion and practice, regarding the detection and treatment of early prostate cancer. Simultaneously, we retrospectively assessed the cases of carcinoma of the prostate seen at our hospital between January 2001 and September 2003. In these patients, we looked for evidence to see if they could have had localized disease and could have been further evaluated for curative therapy. RESULTS: Though 69% of urologists believed in early prostate cancer detection, only 48% attempted early detection and 41% offered these patients, curative therapy. The most common reason for this was the opinion of urologists that, "we do not see early prostate cancer in our practice". An analysis of 153 of our patients revealed that at least 26 of them could have been further evaluated towards curative therapy. CONCLUSIONS: One may not believe in the virtue of treating early prostate cancer. If however we are convinced about its usefulness, we are overlooking many cases who could have been offered curative therapy.