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Published in Advanced Prostate Cancer

Expert Opinion / Cases · August 25, 2015

55 Year-Old Man Presenting in Urinary Retention Found to Have Very High Risk Disease

Jeffrey Tosoian MD, MPH

 

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Jeffrey Tosoian MD, MPH

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  • Huan Wang

    Mar 23, 2016

    The diagnosis for the patient is prostate cancer, cT4NxMx，GS 4+4=8，very high risk group. the patient is 55 year-age, so the life-expectancy is absolutely more than 10 years. Thus if metastatic disease can be excluded, the radical prostatectemy is recommended as first treatment option. Considering perineural invasion (PNI) and extraprostatic extension, neoadjuvant hormonal therapy is required to downstage and downgrade. If the patient has a normal sex activity, the neurovascular bundle with no tumor invading in other side should be attempted to reserve during operation. Acute urinary retention may indicate a large volume of prostate and bladder detrusor decompensation, neoadjuvant hormonal therapy has effect on reducing prostate volume, it is good for decreasing operation difficulty and risk. Postoperation voiding dysfunction should be counseled preoperatively.

  • Waleed Ragab

    Jun 12, 2016

    I think with extraprostatic extention Radical prostatectomy will be accompanied with early local and distant metastasis and lt is better to start hormonal deprivation therapy with early chemotherapy and TURP for the retention

  • Michael U-A Eshiett

    Sep 09, 2016

    TURP plus hormonal treatment and local irradiation therapy would be more effective in treating the cancer than using any of these serially. Of course an urgent referral to an experienced Oncologist is crucial for getting an optimum result.

  • Nov 22, 2024

    Pending Moderator approval.
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