Kindly explain the TRUS guided prostate biopsy report and further treatment.

Hi,

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I am sorry to know about the problem. The biopsy report says that prostate has a cancer disease. Since PSA (prostate specific antigen) is very high, it means that there is a chance that it has spread outside the prostate. The next step will be PSMA PET (prostate-specific membrane antigen (PSMA) positron emission tomography (PET)) scan to find out the areas in the body affected by prostate cancer. If this scan is not available, you can get an MRI (magnetic emission tomography) scan of the abdomen to check local involvement or lymph node involvement along with bone scan to find out bone metastasis.

The treatment depends on the stage of disease. If it has spread to bones, then bilateral orchidectomy (removal of testes) is the standard treatment. If the patient does not want orchidectomy, then he can get regular injections (once in 3 months) to suppress the testicular function. The patient should also take injection Zoledronic acid once in every three to four weeks to control bone spread. Other than these, there is a need for calcium supplements and iron supplements. Please consult the urologist for regular follow up, since the treatment needs to be modified according to the response of PSA and clinical factors.