Q. My father was diagnosed with prostatic adenocarcinoma. What should we do?
Hello doctor,
My 85-year-old father has been diagnosed with prostatic adenocarcinoma. His biopsy reports show Gleason's grade 3+4 (percentage of grade 4 is 30 %), tumor involves 60 % of submitted biopsy. No perineural invasion is seen. His PSA level is 107.69 ng/mL. He has triple vessel heart disease, and the echo result showed EP 60 %. He has very well brain function and is fully conscious. What treatments should we go with at this stage?
Hello,
Welcome to icliniq.com.
You can get a staging workup with PSMA (prostate-specific membrane antigen) scan or bone scan and MRI (magnetic resonance imaging) pelvis.
His high PSA (prostate-specific antigen) does make him a high risk but considering his age. I will not suggest a very aggressive approach to the case.
If the prostate cancer is metastatic, then I will suggest only hormonal manipulation, that is, medical or surgical management and local therapy based on the organ involved.
If it is a localized disease, then EBRT (external beam radiation therapy) can be given if the general condition permits, along with hormone manipulation depending on his general condition.
It will be difficult to commit to one plan as I have not seen him in person. Good luck.
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