Dr Manikumar Singamsetty MD Consultant Dept of Radiation ... · Dr Manikumar Singamsetty MD...
Transcript of Dr Manikumar Singamsetty MD Consultant Dept of Radiation ... · Dr Manikumar Singamsetty MD...
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ESMO Preceptorship Programme
Carcinoma Prostate
Dr Manikumar SingamsettyMD
ConsultantDept of Radiation Oncology
Nagarjuna cancer centre, Vijayawada, INDIA
Prostate cancer – Singapore – 21/11/2018
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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
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ESMO PRECEPTORSHIP PROGRAM
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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.
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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.
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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??
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ESMO PRECEPTORSHIP PROGRAM
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ESMO PRECEPTORSHIP PROGRAM
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ESMO PRECEPTORSHIP PROGRAM
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ESMO PRECEPTORSHIP PROGRAM
� CONFLICTS OF INTEREST : NONE
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ESMO PRECEPTORSHIP PROGRAM
� THANK YOU