Gambaran Kejadian Kanker Prostat pada Penderita DM di RSUP H Adam Malik Medan

Abstract

Background : According to Kemenkes R[, in 2013, the numher of prostate cancer patient is 0.2Yo or approximately 25,012 patients (Kemenkes RI, 2013). Prostate cancer is a malignancy in the prostatic gland and more than 95Yo of prostate cancer is adenocarcinoma, the other 5% is transitional cell and neuroendocrine carcinoma or sarcoma (Presti et al, 2008). Up to now, the etiology of prostate cancer is still unknown, but it involves multifactor and genetic mutations. Research done by Gallagher and LeRoith (2010), Hsieh et al (20t2), Long et al (2012) stated that patients with diabetes have higher risk for cancer (prostate cancer) compared with patients without diabetes, Meanwhile, Waters et al (2009), Xu et al (2013), Kasper et al (2009) identified that patients with diabetes have lower risk for cancer (prostate cancer) compa.red to patients without diabetes. Materials and Methods : Descriptive study that uses the retrospective cross sectional study design done in RSUP H. Adam Malik from January 2014 to December 2014. Samples are derived from all diabetic patients who visited RSUP H. Adam Malik's outpatient and inpatient, which arc 7865 people. Forty-one out of the total underwent prostate biopsy to determine ifthey have prostate carcer and also the characteristic ofthe cancer. Result : Out of 41 male patients that underwent prostate biopsy, 24 patients had prostate cancer, 9 patients did not have prostate cancer and the rest 8 patients were excluded. The patients biopsied were from the age range of 70-74 years old, 9 were found to have cancer (37.5%) and 4 were found to have no cancer (44%). Eight patients (33.3%)were found to have high PSA serum level (>50 ng/mt) and 4 people (44.4%) who does not have cancer have lower PSA serum level which is 5-10 ng/ml. Gleason score is used as a reference on patients with diabetes and prostate cancer. Around 12 patients (50%) have 5-10 Gleason score. Conclusion : In patients with both prostate cancer and diabetes, PSA value is found to be higher compare to diabetes patients without prostate cancer. In additioq the intermediate Gleason score (5-6) are mostly found in patients with both prostate cancer and diabetes

Latar Belakang : Berdasarkan Kemenkes RI tahun 2013 Mengatakan bahwa penderita kanker prostat di Indonesia adalah sebesar 02 96 atau diperkirakan sebanyak 25.012 penderita. (Kemenkes RI, 2015). Kanker prostat adalah suatu keganasan pada kelenjar prostat dan lebih dari 95 % kanker prostat adalah adenocarsinoma, 5 % lainnya transisional sel & neuroendokrin carcinoma/sarcoma (Presti dkk., 2008). Kanker prostat sampai saat ini belum diketahui etiologinya, tetapi diduga melibatkan banyak faktor & rnutasi genetik. Penelitian Gallagher and LeRoith (2010), Hsieh dkk (2012), Long dkk (2012) mengatakan bahwa penderita DM memilki risiko menderita kanker (kanker prostaQ lebih tinggi bila dibandingkan dengan penderita bukan DM. Sedangkan penelitian Waters dkk (2009), Xu dkk (2013), Kasper dkk (2009) mengatakan sebaliknya bahwa penderita DM memilki risiko menderita kanker ftanker prostat) lebih rendah bila dibandingkan dengan penderita tidak DM. Material dan Metode :. Penelitian deskriptif dengan rancangan penelitian cross sectional study refiospektif yang di lakukan di RSUP H. Adam Malik pada periode Januari 2014 - Desember 2014 pada selunrh Pasien Diabetes Mellitus (DM) yang datang ke Poliklinik & Rawat Inap RSUP H. Adam I\4alik Medan sebanyak 7865 orang, den laki-laki yang dilakukan pemeriksaan biopsi prostat sebanyak 4l orang agar dapat di ketahui hasil PA (Kanker Prostatibukan), dan dapat diketahui karakteristik dari kanker prostat tersebut. Hasil : Pada pasien laki-laki tersebut sebanyak 24 orurgmenderita kanker prostat, 9 orang bukan menderita kanker prostat & sisanya yaitu sebanyak S orang tidak representatif (ekslusi). Penderita Kanker Prostat dan yang bukan, di biopsi pada kisaran amar 70-74 tahun sebanyak 9 (37,5 oA kanker, dan sebanyak 4 (44%) bukan kanker. Nilai PSA dengan Kanker Prostat terbanyak dengan nilai > 50 nglml sebanyak 8 orang (33,3yo), dan bukan kanker terbanyak dengan nilai 5-10 ng/ml sebanyak 4 orang (44AW. Menunjukkan gambaran nilai Skor Gleason pada penderita DM dengan Kanker Prostat. Ternyata Skor Gleason terbanyak pada kisaran 5-10, yaitu sebanyak 12 orang (50%). Kesimpulan : Pada Penderita Kanker Prostat dengan DM didapati nilai PSA lebih tinggi dari pada Penderita Bukan Kanker Prostat dengan DM, serta Kanker kostat dengan DM memiliki nilai Skor Gleason terbanyakpada diffrensiasi sedang (5-6)