ESMO Preceptorship Programme

Carcinoma Prostate

Dr Manikumar SingamsettyMD

ConsultantDept of Radiation Oncology

Nagarjuna cancer centre, Vijayawada, INDIA

Prostate cancer – Singapore – 21/11/2018

ESMO PRECEPTORSHIP PROGRAM

� 72 year male� Diabetic, hypertensive� Evaluated for hematuria and urinary incontinence.

� Ser PSA-29� MRI- prostate confined disease with seminal vesicle invasion� Bone scan – ve� Biopsy- Prostatic adenocarcinoma GS8

ESMO PRECEPTORSHIP PROGRAM

ESMO PRECEPTORSHIP PROGRAM

WHAT NEXT?

� All treatment options explained � Patient underwent Robotic prostatectomy+ lymphnode

dissection

� pT3bN0M0 with perineural invasion� Prostatic adenocarcinoma� Margins -ve� Advised Adjuvant RT but patient refused.

ESMO PRECEPTORSHIP PROGRAM

� Kept on follow up.� 2 months post op Ser PSA- 0.4� 4 months post op Ser PSA- 0.6� Complete work up done - -ve.� Patient received adjuvant RT to post op

bed 6000 cGy/ 30 #.� Patient was kept on follow up.

ESMO PRECEPTORSHIP PROGRAM

� 9 months post RT, On regular follow up Ser PSA- 0.4

� Progressively raising S. PSA� Psma Scan done – 2.7 X 2 cm lesion near to post op

bed.� What next?� ADT??/ Resurgery??

ESMO PRECEPTORSHIP PROGRAM

ESMO PRECEPTORSHIP PROGRAM

ESMO PRECEPTORSHIP PROGRAM

ESMO PRECEPTORSHIP PROGRAM

� CONFLICTS OF INTEREST : NONE

ESMO PRECEPTORSHIP PROGRAM

� THANK YOU