A 50 year old male was referred into hospital by their GP following complaints of frequent urination at night and haematuria . Patient had a blood test which demonstrated elevated PSA

Diagnosis, Treatment, and Follow-up Imaging for Prostate Cancer: A Case Study

 

Following the outcome of MRI and the transrectal ultrasound having established that the patient has prostate cancer, the first approach is to continue with further imaging to illustrate the cancer burden as well as the impacted lymph nodes that guide treatment determination. Thus, to identify the cancer type, the physician should examine a piece of prostate tissue under a microscope to determine if the cells are cancerous. The patient's ailment stage should be identified at this point too. Staging encompasses establishing whether the cancer has extended to bones and lymph nodes. Future imaging will still be required (Strategic Plan for Prostate Cancer Research in Nigeria, 2020).

Treatment

The prostate cancer treatment approach is a "one-size-does-not-fit-all" model. Being a man under the age of seventy who works out regularly and is generally fit, the recommendation is to have surgery to remove the prostate gland because it is localized cancer. When undergoing surgery, the surgeon will undertake a rib cage procedure to completely eliminate the prostate, as well as local tissues or lymph nodes adjoining it that could be having cancerous cells. The decision for surgery is based largely on the degree of freedom from illness and the realistic chances of curing the patient. It can also be debated that this patient will be placed under watchful waiting given his low-risk category. Hormonal therapy can be used for metastatic utilization. Nevertheless, hormone therapy is a secondary option to surgical intervention (Murphy et al., 2018) because it is unsuitable for patients that have no metastasis.

Follow-up Imaging

When the patient's cancer stage reaches greater than T2 or has extended to detachable lymph nodes, follow-up imaging will likely be adopted. A prostate-specific antigen test should be conducted every three to six months after such cancers have been treated, accompanied by a CT scan or a MRI (Wongcharoen et al., 2023).In the above case study of a twenty-eight-year-old male with low-risk prostate cancer, no imaging is required. This is because the patient is a young adult obtaining positive outcomes (Gleason score less than six) of low volume with the International Society of Urological Pathology (ISUP) grade one that is localized. Thus, there will be no follow-up imaging due to the lack of disease progression. Following the first five-year term after diagnosis, the primary focus will be avoiding repeatedly scanning lesions unless physical examination and lab assessments indicate potential metastasis (Wongcharoen et al., 2023).

 

References

Murphy, S. L., Smigal, C., Wu, J., Krempels, S., Stanislaus, M., & Huo, D. (2018). Quantifying the surgical care pathway for men with prostate cancer in the United States. Cancer, 124(14), 3014-3021. DOI:10.1002/cncr.14372