Therapeutic Approach for Nonmetastatic Prostate Cancer

Video

Therapeutic Approach for Nonmetastatic Prostate Cancer

January 2014

  • A 66-year old retired African American male presents with reduced urinary flow and hematuria.
  • PMH: High blood pressure. Currently taking enalapril 10 mg.
  • FHx: Father lung cancer — age 74.
  • Patient walks 3 miles a day.
  • PSA 9.8 ng/ml
  • Prostate biopsy shows Gleason 7 (4+3) prostate cancer
  • Undergoes robotic-assisted laparoscopic prostatectomy (RALP) and pelvic lymph node dissection (PLND)
  • Results show:
    • pT3b (focal extracapsular extension and seminal vesicle invasion) — margins negative
    • N1
    • M0
  • Post-operative PSA=0.64 ng/ml
  • Patient undergoes adjuvant radiation therapy and is started on leuprolide acetate.
  • PSA drops to undetectable levels

January 2016

  • PSA starts to rise to 0.3 ng/ml
    • Repeated 3 months later — 0.7 ng/ml
    • Bone scan and prostate-specific membrane antigen (PSMA) scan both negative
    • Diagnosis nonmetastatic castration-resistant prostate cancer (CRPC)
    • Patient declines additional therapy at this time

November 2017

  • PSA continues to rise over the next 18 months going up to 9.8 ng/ml
  • Bone scan shows lesion in the left superior pubic ramus
  • Patient is asymptomatic
Related Videos
Stephen T. Oh, MD, PhD, an expert on myelofibrosis
Stephen T. Oh, MD, PhD, an expert on myelofibrosis
Stephen T. Oh, MD, PhD, an expert on myelofibrosis
Stephen T. Oh, MD, PhD, an expert on myelofibrosis
Stephen T. Oh, MD, PhD, an expert on myelofibrosis
Stephen T. Oh, MD, PhD, an expert on myelofibrosis
Stephen T. Oh, MD, PhD, an expert on myelofibrosis
Stephen T. Oh, MD, PhD, an expert on myelofibrosis
Related Content