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Conventional prostatic adenocarcinoma
What should be the next treatment? How can we treat this Conventional prostatic adenocarcinoma with neuroendocrine differentiation and an extensive small cell type? He has aged alot , psa is 1.1, Intense FDG uptake noted in peripheral zone of right lobe of enlarged prostate (measures 5.0x4.3 cm);
SUVmax 10.9
FDG avid bilateral external iliac, left obturator nodes; ~ 3.1x2.5 cm, SUVmax 9.5
FDG avid few bilateral hilar, subcarinal, paratracheal, prevascular nodes (largest measures 1.8x0.9 cm;
SUVmax 8.5), few of them demonstrating hyperattenuation of NCCT thorax: favours the granulomatous etiology.
No other significant adenopathy noted
FDG avid extensive lytic and marrow lesions (few with associated soft tissue; Intraspinal extension at the level of few dorsal-lumbar vertebrae and sacrum) are noted involving axial and proximal appendicular skeleton; SUVmax 9.5.
Variable FDG avid varying sized hypodense lesions in both lobes of liver; largest measures ~ 2.5x3.0 cm (segment V), SUVmax 14.5
The reports suggest that it is advanced/ metastatic prostatic cancer. Needs treatment with hormone blockers and also if needed anti androgen tablets or injections .. based on aggressiveness and general condition a few patients might need chemotherapy too if medically fit
Next Steps
if possible providing the PET scan report as image might help in guiding further treatment
Health Tips
Though prostate cancer is not very aggressive , the above PET report which has been shared shows multiple metastasis. so might need to be started on hormone blockers therapy at the earliest
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