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Suggest Treatment For Metastatic Prostate Cancer

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Posted on Tue, 13 Dec 2016
Question: Hi. My grandfather has the history of prostate cancer. Last year it started spreading to the liver. Using kinase inhibitors we managed to stop the growth of the tumor and he recovered. This summer, however, he was diagnosed with a cyst in the same area. It has been growing rapidly. The MRI scans show that contrast substance is accumulating, which, we have been told, is a sign that it is benign. However, the doctors in Russia (that's where he is right now) keep saying that it can be cancerous and that surgery is not an option because it's 15x10 cm and near liver. They say chemotherapy is the way to go. Could you please tell me a) whether it matters if it's a cyst or a benign tumor and how the treatment differs in each case b) whether MRI scans can be proof that it is benign and not cancerous c) whether surgery is possible and what type of surgery should be considered d) whether chemotherapy can improve or exacerbate the condition. Thank you.
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Answered by Dr. Indranil Ghosh (1 hour later)
Brief Answer:
Benign or cyst doesn't grow rapidly

Detailed Answer:
Hi
Thanks for your query.

First of all, prostate cancer spread to liver is not treated by kinase inhibitor. It is treated by hormonal therapy and chemotherapy. Primary liver cancer is treated by kinase inhibitor. So I am not really sure what is going on with him.

Now, the rapid growth and large size goes against benign tumor or cyst. MRI can't conclusively differentiate between benign and cancer. More likely it is cancerous growth. Hence requires treatment. Benign or cyst doesn't require treatment.

So I would suggest a biopsy from this, then treat accordingly. Surgery looks difficult, considering the size. Chemotherapy is definitely an option, if he can tolerate. Other option is TACE or chemo inside liver artery.

Hope this helps.
Regards
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

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Suggest Treatment For Metastatic Prostate Cancer

Brief Answer: Benign or cyst doesn't grow rapidly Detailed Answer: Hi Thanks for your query. First of all, prostate cancer spread to liver is not treated by kinase inhibitor. It is treated by hormonal therapy and chemotherapy. Primary liver cancer is treated by kinase inhibitor. So I am not really sure what is going on with him. Now, the rapid growth and large size goes against benign tumor or cyst. MRI can't conclusively differentiate between benign and cancer. More likely it is cancerous growth. Hence requires treatment. Benign or cyst doesn't require treatment. So I would suggest a biopsy from this, then treat accordingly. Surgery looks difficult, considering the size. Chemotherapy is definitely an option, if he can tolerate. Other option is TACE or chemo inside liver artery. Hope this helps. Regards