Implications of androgen-deprivation therapy in patients with prostate cancer: A case study.
S.R., a 65-year-old male with a history of prostate cancer, went to a cancer center in 2003. He had developed symptoms of bladder outlet obstruction in 1999 and was seen by a urologist. His baseline prostate-specific antigen (PSA) was 44 ng/ml. On physical examination, his prostate was enlarged, and a biopsy in January 2000 revealed adenocarcinoma with a Gleason score of 8. A metastatic workup, including a bone scan and a computed tomography scan of the abdomen and pelvis (CT A/P), was negative for evidence of metastatic disease. S.R. received conformal external beam radiation, and the luteinizing hormone-releasing hormone agonist leuprolide acetate was initiated. Following treatment, his PSA nadired to 0.2 ng/ml, and he did well until 2002, when his PSA started to rise. A reevaluation CT A/P revealed enlarged retroperitoneal and pelvic lymph nodes, and a bone scan was positive for metastatic disease. He underwent a bilateral orchiectomy in November 2002.
Doyle-Lindrud
Susan
S
Gallo Prostate Cancer Center, The Cancer Institute of New Jersey, New Brunswick, USA. Lindrusm@umdnj.edu
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D003131:Combined Modality Therapy; D004164:Diphosphonates / Q000009:adverse effects; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects; D007571:Jaw Diseases / Q000139:chemically induced; D016729:Leuprolide / Q000009:adverse effects*; D008297:Male; D009919:Orchiectomy; D010020:Osteonecrosis / Q000139:chemically induced; D010024:Osteoporosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D020266:Radiotherapy, Conformal; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D000077211:Zoledronic Acid
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D007987:Gonadotropin-Releasing Hormone; D000077211:Zoledronic Acid; D017430:Prostate-Specific Antigen; D016729:Leuprolide