Epidemiologic clinical and therapeutic profile of bladder cancers in two tertiary hospitals in Douala, Cameroon

Abstract

Background: Bladder cancer is a medical and surgical burden in both urology and oncology and constitutes the ninth most common cancer worldwide. Regional lymph nodes, bones, lungs, and liver are the most common metastases from bladder cancer. Bladder cancer has higher mortality if diagnosed late, thereby emphasising the importance of its early diagnosis. The purpose of this study was to evaluate the epidemiologic, clinical, and therapeutic aspects of bladder cancers in the city of Douala.

Methods: This study was a retrospective descriptive record-based study over a period of 10 years. We reviewed files of patients who were diagnosed with bladder cancer from 1 January 2009 to 31 December 2019. The study was carried out in the Douala General Hospital (DGH) and Douala Laquintinie Hospital (DLH).

Results: A total of 34 patients were included in our study. Bladder cancer consisted of 16.87% of urogenital tumours in our health facilities. Of the patients, 55.9% (19/34) were from DGH, while 44.1% (15/34) of patients were from DLH. Most of the patients were females (52.9%, 18/34). Most of the patients were within the age group of 50–59 years (35.3%) and  60–69 years (26.5%). Patients who were smoking tobacco comprised 52.9%. Concerning medical antecedents, 50% of the patients were hypertensive patients, while 41.2% and 35.3% of the patients had bilharziasis and diabetes respectively. The most common presenting symptoms were haematuria (97.1%) and lower abdominal pain (94.1%). Squamous cell carcinoma was the most common histological finding (58.3%). Regarding differentiation of cells, 58.3% of the patients were at Grade III, while 16.7% were at Grade II of bladder cancer. Chemotherapy was the only treatment for 29.4% of patients, while 50% of the patients had chemotherapy and surgical interventions. In this study, 12 patients (35.3%) died.

Conclusion: Delayed diagnosis of bladder cancer is very common in our setting due to late presentation at consultation and this is associated with high morbidity and mortality. There is a need to improve bladder cancer management in our setting and this will require better hospital equipment with access to endoscopy, which will aid in early diagnosis.