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Objective: To assess the survival patterns in female breast cancer patients treated in eastern Nigeria., Design: A prospective study., Setting: Nmadi Azikiwe University Teaching Hospital, Nnewi, Iyi-Enu Mission Hospital Onitsha and Aca Specialist Hospital, Nkpor, Onitsha, Nigeria., Subjects: Female breast cancer patients undergoing treatment offered by a single surgical practice., Intervention: The patients were offered modified radical mastectomy, multidrug chemotherapy and hormone therapy. The patients were subsequently followed up for significant periods or until death. Patients who did not complete the treatment or were lost to follow up were excluded from further analysis., Results: Out of 124 patients seen during the period, seventy eight were evaluable. The mean age was 44 years, 63% were pre and peri-menopausal while 56% had advanced diseases (Stages III and IV) at presentation. The overall median survival was 31 months but was better for Stages I and II (42 months) than for Stages III and IV (20 months). There was a slight survival advantage for post-menopausal patients. Distant metastases were most often seen in the vertebral tree and in the lung fields., Conclusion: Survival from breast cancer is still poor in our set up. Efforts at earlier diagnosis must be aggressively pursued. Multi-centre trials are advocated in order to determine whether breast cancer pursues a more aggressive course in Nigerians.

Analyses of total and prostatic acid phosphatase levels in patients undergoing prostatectomy at Iyi-Enu Hospital, Ogidi, Nigeria between June, 1989 and May, 1992 showed the following: total acid phosphatase sensitivity 72%; specificity 27%; predictive value 28% and while prostatic acid phosphatase sensitivity 72%; specificity 41%; predictive value 50%. While the prostatic acid phosphatase is better than total acid phosphatase both suffer from unacceptably low specificity and high rate of false positives. The clinical value is therefore poor and decision on surgery should be made on other parameter, especially rectal examination.

One hundred and forty consecutive patients were offered transvesical prostatectomy after haematological and urinary investigations but without urography. The results of treatment are comparable to those in similar setting where urography had been performed as a routine procedure. While the renal function was generally poor in the earlier period, improving later in the study period, no urinary abnormality which would have affected outcome was missed by clinical assessment and other investigations. In view of the high cost of urography and possible adverse effects we believe that unless specifically indicated by presence of haematuria or loin pain urography is unnecessary in the diagnostic work of patients for transvesical prostatectomy.