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Suggest Treatment For Advanced Prostate Cancer

Posted on Mon, 18 May 2015

Question: 68 years old male member who is experiencing bone pain, urine frequency and urgency. but there is no history of hematuria. he was diagnosed to have prostate cancer in 2007. TURP was done in 2009. No chemotherapy or Radiotherapy was given. currenlty he is on Harmonal therapy. CT scan was done recently which showed Bladder is relatively small in size with mural thickening and mucosal irregularity on its base and poster inferior aspects merging with the upper surface of prostate. The latter appears enlarged. Bone scan was done which showed metastasis. Diagnosis was made as malignant neoplasm of Prostate. Treating doctor advised only Bilateral Orchiectomy with Cystoscopy and J stenting as there is pressure on both ureter.
Please advise if the requested procedure will give benefit to this member. As I remember, In stage IV Prostatic cancer, recommended surgical intervention is Radical Prostatectomy with bilateral orchiectomy.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
He has advanced prostate cancer .

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have been diagnosed to have Cancer of the prostate in 2007 and only TURP was done in 2009.

Now you have been detected to have metastasis in bones suggesting advanced prostate cancer This is the cause of your bone pain.

Since prostate cancer is hormone dependent it is primary aim to castrate the patient to cut off the hormone (Testosterone) Since it has already spread to distant location(Bone) there is only one treatment option now that is castration(Bilateral Orchidectomy) followed by hormonal therapy.
so as to keep the disease under control to some extent. (Orchidectomy),

Please note that Radical Prostatectomy is advised only when cancer is confined to Prostate and not infiltrated beyond capsule of the prostate.

Consult qualified Urologist or Medical Oncologist for further treatment.

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (1 hour later)

please be advise if after bilateral orchiectomy, still there is any need for hormone replacement therapy? what about the mortality rate after orchiectomy

Answered by Dr. Dr. P. T. Patil (8 hours later)

Brief Answer:
There is no mortality due to Orchidectomy .

Detailed Answer:
Hello
Thanks for follow up.

There is no mortality due to Orchidectomy itself but is due to the primary cancer of the prostate which is advanced to bones .

As there Testosterone is secreted by other tissues like adrenal and accessory tissue located at various organs you need to take hormone therapy to cut of the androgen completely to arrest the further spread of the cancer.

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar