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Dr. Andrew Rynne

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Diagnosed prostate cancer. Scans show increasing contrast enhancement in the nodular area. What to do?

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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1464 Questions

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Posted on Tue, 11 Jun 2013 in Cancer
Question: hello doctor,
Here i want to discuss a case of my father who has detected a prostate cancer. I would like to ask how should we go about it ? what do you recommend ?
report says :
"Ca prostrate showing in homogeneous signal intensity with few small cystic areas, hypertrophy of transitional & central zones with moderate sized oval round to shaped area of altered signal intensity seen in the central to left paracentral along with suspicious capsular irregularity in left lateral & posterior aspects with loss of fat plane between the prostrate & left seminal & altered signal intensity in left seminal visicle.
Multi phase contrast scans showing increasing contrast enhancement in the nodular area left posterior cortical bulge & in the left seminal vesicle the latter suggesting involvement with the disease process


As per reports do you think is it curable and how should we go about it ?
he has taken a dose of injection leupride deport on 4th may and second dose he will take after 3 month. he has taken a dose of injection zyrona 4mg in 100 ml saline on 20th may after that he has having fever ( 100.3 ) and having tab tunox for next 7 days.
thanks
doctor
Answered by Dr. Indranil Ghosh 1 hour later
Hi
Thanks for your query.
It appears that your dad has got locally advanced prostate cancer, as the seminal vesicle has got involved on the MRI. The bone scan does not show any spread to bones.

The treatment is lupride every 3months and then radiotherapy to the prostate area starting 3 mo after the first dose of lupride. The zoledronate(zyrona) is usually given only if bone spread is there. May be only one dose was given to strengthen the bones. Please check with your doctor. Fever after zoledronate is also common.

Hope I have answered your query. I will be available to answer further followup queries, if any.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh 56 minutes later
Hello doctor,

Thanks for reply. Doctor recommended injection Zyrona for bone strength. i will defiantly check with our doctor.
Is it curable ? how many doses of leupride you recommend? presently our doctor didnt told me about radiotherapy.
Do you know about medicine saw palmetto?
thanks
doctor
Answered by Dr. Indranil Ghosh 53 minutes later
It is not really curable but controllable. Some patients do enjoy quite a few years of good quality of life. Lupride should continue for at least 2 years provided blood level of PSA becomes and stays normal.

Saw palmetto is a traditional medicine used for benign prostate enlargement. There is no or little data on cancer prostate. Hence it cannot be recommended for this use.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh 15 minutes later
hello doctor,

should we start radiotherapy after 3 months of leupride dose? can we control more with radiotherapy ?
what are the side effects of radiotherapy and leupride injection ?
thanks
mekhla
doctor
Answered by Dr. Indranil Ghosh 11 hours later
Control with radiotherapy is better than only lupride, hence it is preferable.
USually it is started 2-3 months after first dose.

lupride may cause weakness, loss of muscle mass, elevated sugar, cholesterol, etc. Radiotherapy may cause diarrhea, lower abdominal pain, skin reactions, etc.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh 2 hours later
could you refer good doctor in Jaipur ?
i think radiotherapy can be taken once in the life time. is it right ? is it painful ?
my father has gone through bypass surgery in the 2002. Is therapy fine for him ?
thanks
XXXXXX
doctor
Answered by Dr. Indranil Ghosh 23 minutes later
Of course he can take RT even if he has had a bypass surgery. And it is for one time only. But if it has not spread to other sites then better to try everything now than to keep for later.

You can XXXXXXX Dr XXXXXXX XXXXXXX in Fortis JAipur (medical Oncologist). He will guide you about further treatment and send to radiation oncologist if required.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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