Stage 4 Prostate Cancer
- Dr. Malwinder Singh Sandhu
- Jul 8, 2024
- 1 min read
A gentleman from Sabah endured years of lower urinary tract symptoms and was initially treated for benign prostatic hyperplasia. Unfortunately, his condition persisted, and he was eventually diagnosed with prostate cancer, with a PSA level exceeding 100 and a biopsy revealing adenocarcinoma with a Gleason score of 4 + 5.
Upon consulting with me, a PSMA PET scan was conducted, uncovering stage 4 prostate cancer with metastases to the bone, lymph nodes, lung, and pericardial effusion.
Given his castrate-sensitive prostate cancer, I initiated oral targeted therapy combined with a 3-monthly GnRH analogue. He responded well to the treatment and has been flying down every three months to replenish his medications.
After nine months, a follow-up PSMA PET scan showed a complete radiologic response in all metastatic sites except the prostate. Consequently, I administered SBRT to the prostate to eradicate the remaining active cancer cells.
I am now looking forward to his next PET scan to evaluate the potential for treatment de-escalation.
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