Neurologic complications of prostate cancer.
Neurologic complications continue to pose problems in patients with metastatic prostate cancer. From 15 to 30 percent of metastases are the result of prostate cancer cells traveling through Batson's plexus to the lumbar spine. Metastatic disease in the lumbar area can cause spinal cord compression. Metastasis to the dura and adjacent parenchyma occurs in 1 to 2 percent of patients with metastatic prostate cancer and is more common in those with tumors that do not respond to hormone-deprivation therapy. Leptomeningeal carcinomatosis, the most frequent form of brain metastasis in prostate cancer, has a grim prognosis. Because neurologic complications of metastatic prostate cancer require prompt treatment, early recognition is important. Physicians should consider metastasis in the differential diagnosis of new-onset low back pain or headache in men more than 50 years of age. Spinal cord compression requires immediate treatment with intravenously administered corticosteroids and pain relievers, as well as prompt referral to an oncologist for further treatment.
Benjamin
Ramsis
R
Keck School of Medicine of the University of Southern California, Los Angeles, USA. rbenjamin1@partners.org
D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000209:etiology / Q000556:secondary*; D003907:Dexamethasone / Q000627:therapeutic use; D005194:Family Practice; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008577:Meningeal Neoplasms / Q000556:secondary; D009362:Neoplasm Metastasis; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D013117:Spinal Cord Compression / Q000188:drug therapy / Q000209:etiology; D013120:Spinal Cord Neoplasms / Q000556:secondary
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone