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How timely prostate cancer diagnosis helped save two lives
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How timely prostate cancer diagnosis helped save two lives

Dr Mohammed Shahid Ali recalls how surgical and non-surgical methods played a crucial role in managing the condition faced by a techie and a businessman
Prostate cancer is said to be advanced when it has spread to other parts of the body, apart from the prostate gland.
Dr. Ali encountered a rare symptom where a 68-year-old retired businessman came with a swelling on his right leg for the past six months. (Photo by Anantha Subramanyam K / Happiest Health)

Prostate cancer is a common type of cancer in men. The modalities of treatment may, however, vary based on the stage of the cancer. When prostate cancer is detected at an early stage, the cure rates are high, and the individual can eventually lead a normal life.

If the cancer has spread beyond the confines of the prostate, it is termed as locally advanced disease or advanced prostate cancer. Individuals diagnosed with advanced prostate cancer need additional treatment along with surgery in the form of anti-androgen medicines and radiotherapy (multimodal therapy), as the chances of recurrence of the cancer increases with only a single mode of treatment. Hence, the Prostate- Specific Antigen (PSA) test of the individuals should be assessed every three months after radical prostatectomy to monitor the PSA levels and detect recurrence at the earliest.

Even though the condition is advanced, there are treatment options which include surgical and non-surgical methods which help manage the condition and enable individuals to have a better quality of life like in these two cases.

Early prostate cancer treated with robotic surgery

A few months back, a 54-year-old IT professional from Bangalore scheduled a consultation after he frequently noticed blood in his urine. He also complained of feeling unusually tired and unable to concentrate on his work. After assessing his symptoms, examination of prostate, serum PSA levels, and prostate biopsy, he was diagnosed with early prostate cancer. Elevated PSA levels indicate an abnormality or cancer in the prostate gland.

Interestingly, another striking feature about this case was that the individual had one symptom- blood in urine which is usually a symptom seen in an advanced stage of cancer. As this was a case of early prostate cancer, we further evaluated his urinary tract with imaging and ureteroscopy of his upper tracts.

After extensive evaluation, it was revealed that he also had a urothelial cancer in his right kidney, a type of cancer which begins in the urothelial cells that line the urethra, bladder, ureter and renal pelvis. This cancer was causing bleeding in his right kidney resulting in symptoms like blood in the urine.

The individual was, however, fortunate as both the prostate cancer and urothelial cancer were in the early stages. The prostate was removed, and urothelial cancer was also removed using robotic surgery with minimal postoperative morbidity and early recovery. The techie has been continuing his follow-ups and is currently working and carrying out his daily activities without any hindrance. In this case, early detection, detailed examination, and treatment has been able to save the life of the person with dual cancers.

Advanced prostate cancer with a rare symptom

Usually, prostate cancer is said to be advanced when it has spread to other parts of the body, apart from the prostate gland. Symptoms include frequent urination, blood in urine or semen, weakness and back pain. However, I encountered a rare symptom where a 68-year-old retired businessman from Bangalore came with a swelling on his right leg for the past six months.

On experiencing terrible swelling on his leg, the individual consulted a health professional who diagnosed it as deep vein thrombosis (DVT) of the leg and prescribed him some medications. However, even after six months when the swelling didn’t subside, he consulted me.

To analyze the exact cause of his swelling, a doppler test was conducted and it was found that the vein supplying the blood to the lower part of the body was blocked due to formation of a huge clot. This had led to swelling in the legs. On further evaluation, it was found that the person was taking blood thinners to dissolve the clot as suggested by a doctor he had consulted earlier. However, the swelling didn’t subside. He also complained of urinary problems such as difficulty in passing urine.

A biopsy was done further to understand the problem which revealed that he was having an advanced prostate cancer. The cancer had spread to the lymph glands of the pelvis and around the left ureter. Due to enlargement of the lymph nodes, which were compressing the veins, he experienced swelling in the leg.

A surgery was conducted, and he was put on medications. Since it was an advanced case of prostate cancer, it couldn’t be cured. However, his blood clot has resolved and swelling in the leg has healed and his condition is now under control. This case shows that for men aged 40 years, cancer screening for prostate is essential and it is better to screen early and treat accordingly.

–As told to Steni Simon

The author is a consultant urologist, andrologist, Robotic Surgery & Renal Transplantation specialist at Manipal Hospital, Old Airport Road, Bangalore. 

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