Q. How can we treat prostate cancer patients conservatively?
Hello doctor,
My dad is a prostate cancer patient and underwent IGRT last year with a Gleason of 3+4. I have three questions: He has already taken seven Zoladex injections and his PSA over the last two years has been less than 0.20 ng/mL, his last being 0.03 ng/mL. How many more doses does he need to take? The doctor suggests 8 to 12 injections. Is there a standard treatment for it? He feels weak in spite of consuming vitamin tablets. How can we improve that? He has been complaining of stool in his blood occasionally. He underwent a colonoscopy with gastroscopy, which reveals angiodysplasia of the left colon and mild hemorrhoids. The gastroenterologist suggested an APC. Any recommendations to address the issues in a more conservative way?
Hello,
Welcome to icliniq.com.
According to your query: Eight to twelve injections is the standard. For your dad, I suggest giving the same for three years (12 injections) of treatment. As testosterone levels drop, weakness sets in. This is a side effect of treatment If he is unable to tolerate the weakness, or if daily activities are hampered, then we could stop with two years or two and half years of treatment. APC (active protein C) test is quite conservative in my opinion. The more aggressive therapies are colostomy (colonic bag attached to stomach wall) and colectomy (removal of the diseased colon). If steroid enema is not tried, it can be tried prior to APC.
I hope I have cleared your doubts. Thank you.
Hello doctor,
Thank you for the clarification. He is doing well in terms of extreme weakness. He feels weak but is able to do his normal day-to-day chores so I think he can complete the 12 doses. Suggested Sucralfate suspension which he consumed for a couple of days but that apparently caused swelling under his eyes, and feet. Also, does APC solve the issue permanently or will it need to be redone every time a similar issue is encountered, and how soon does it heal? We had done a PSMA PET scan before and after the radiation therapy to confirm that the lesions had gone away and which was good. The doctor suggested once again to do the scan. Is it necessary and how frequently should that be done?
Hello,
Welcome back to icliniq.com.
PSMA PET (prostate-specific membrane antigen positron emission tomography) patients with follow-up as well as blood PSA (prostate-specific antigen) are monitored every three months for up to five years. If cost is an issue, then PSA alone can be done monthly thrice. Remember that PSA escape is possible, where some tumors stop secreting PSA. So, the PSA test will be normal but the cancer will be spreading inside. To avoid this, we do the yearly scan. Swelling in the eyes, the body may be an allergic reaction to Sucralfate (not the same as a steroid). Steroid enema can be tried in a hospital setting with all precautions. I suggest Entofoam (topical treatment of ulcerative proctitis of the rectum) enema. APC (activated protein C) may be required repeatedly. Generally, the bleeding settles with one or two sittings. If it recurs repeatedly, he may be better off going for surgical removal of the diseased portion of the bowel, as a permanent solution. I hope I have cleared all your doubts.
Thank you.
Was this answer helpful?
|Same symptoms doesn’t mean you have the same problem. Consult a doctor now!
Related Questions:
What causes an increase in prostate-specific antigen post-radiotherapy?
Your PSA (prostate-specific antigen) has been rising post-radiotherapy ... This will show any recurrence in the prostate or lymph nodes or elsewhere ... Read full
Prostate Cancer, a NightmareWhat Is Prostate Cancer ... The prostate is a gland within men's body structure that is important for the vital activity of sperm ... TRUS (Transrectal Ultrasound) scan is used to detect the Read full
What to do if PSA levels increase after stopping Leuprolide?Hello doctor, I had stage III prostate cancer fifteen years back ... This suggests either lymph nodes or margins were positive, and there may have been a prior rise in PSA (prostate-specific anti Read full
Also Read Answers From:
Comprehensive Medical Second Opinion.Submit your Case
iCliniq's FREE Newsletters
Expert-backed health and wellness information, delivered to your email.
Thank you for subscribing to our Newsletters!
Also Read
PCOS and Liver Problems
The hormonal imbalances in polycystic ovary syndrome could cause liver diseases. Read the article to know the relationship between these medical conditions. Read more»
Inferior Alveolar Nerve Lateralization Technique
The inferior alveolar nerve lateralization technique is a surgical lateralization technique to reposition the nerve. Read the article to know more about this. Read more»
COVID-19 and Ebola: Similarities and Differences
This article gives a comparison and broader overview of the outbreak of the two deadliest diseases that showed a greater incidence over the last two decades. Read more»
Ask your health query to a doctor online?
Ask a Radiation Oncologist Now* guaranteed answer within 4 hours.