Thesis:

Obesity as a risk factor for prostate cancer aggression among cancer patients in selected hospitals in Kiambu county, Kenya.

In the World, it is a growing concern as one third people is obese or overweight. Obesity is seen in all age groups, both genders and all ethnicities at variable rates and the prevalence of which has more than doubled since 1980. The purpose of this study was to determine obesity as a risk factor for the aggressiveness of prostate cancer among male patients in some hospitals within Kiambu County, that is, Gatundu Level 5 Hospital, Kiambu Level 5 Hospital, and Thika Level 5 Hospital. This was study on the prostate cancer patients in the chosen hospitals. Primary information on the clinical history of PC patients was obtained with use of clinical records. A purposive sampling method was taken to target a sample size of 256 respondents from the 3 selected hospitals. This research was made by purposive sampling and convenience sampling technique. Since the retrospective aspect of obesity on PC was being analyzed, an analytical retrospective research design was used. Structured questionnaires were used to collect data from PC patients through follow up by phone call interviews and In depth interview guide to get open ended information from the healthcare professional’s view on PC and obesity. The collected data was then cleaned, analyzed using SPSS version 28 and inferential statistics such as multinomial logistic regression analysis, and Chi-square tests of association at 0.05 level of significance were done to establish a relationship between the variables. It was also established from the findings that men in Kiambu County had a high level of prostate cancer aggression (cumulative of 52.9). The findings showed that, with more than 40 per cent of those with PC above 45 years, the other factors used in the study (age, marital status, length of diagnosis and stage of cancer) significantly affects the aggression of prostate cancer (p < 0.05). Prostate cancer aggression was significantly associated with obesity with the association between PC aggression with ever been obese (p=0.018), unfortunately still obese (p=0.0111), related PC symptoms with obesity (p=0.003), difficulty managing PC with obesity (p=0.017) and deaths from obesity (p=0.000). Specifically, age, tumor characteristics, family history, diet and lifestyle of PC patients were all further found to be confounding factors which lead to PC aggression. This study had a key conclusion: understanding how high aggression affects this cancer can assist with clinical decision making and patient education to promote personalized approach in the care of this prostate cancer. Recommendation: The health sector should lead a regular monitoring of the weight, body composition, etc. health indicators (blood pressure, cholesterol levels, etc.) in order to assess progress and recommend these to patients should they be necessary.