Charles Ryan, MD: The Role of Abiraterone Plus Prednisone in Patients With Diabetes

Is abiraterone plus prednisone a concern considering the patient's history of diabetes?

CASE: Metastatic Prostate Cancer (Part 2)

Mathew J is a 61 year old African American male who presented to his primary care physician with lower urinary tract symptoms, including sporadic hematuria. He complains of abdominal pain and low back pain starting four months ago and increasing in frequency. Prior medical history includes non-insulin dependent diabetes mellitus, well-controlled on metformin since 2006. The patient was referred to urology for further evaluation. ng/ml.

During his most recent follow-up exam, the patient complained of intermittent back pain and increasing fatigue.

• Digital rectum exam revealed nodular prostate /L
• Serum PSA level; 129 ng/ml
• Alkaline phosphatase, 258
• TRUS/prostate biopsy: 53 gram prostate, 12/12 cores (+), Gleason 4 + 5
• CT indicates blastic lesions to lumbar spine and pelvis
• Bone Scan positive for T/L spine, pelvis, right femur, scapula
• ECOG performance status, 1