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Abstract: The patient in this case is an elderly male who was diagnosed with prostate alveolar adenocarcinoma after an external examination revealed an elevated PSA, and was treated with antiandrogen therapy at the hospital. The patient was discharged after 2 weeks of hospitalization and is currently under continuous outpatient follow-up.
Basic information】Male, 76 years old
Type of disease】Prostate cancer
Hospital】Xiang Ya Hospital of Central South University
Date of Consultation】March 2022
Treatment plan】Surgical treatment (laparoscopic radical prostate cancer surgery)
Treatment Period】2 weeks hospitalization, continuous follow-up
Treatment effect] The disease was controlled and PSA decreased compared with that before surgery
I. Initial consultation
The patient was 76 years old and came to the clinic accompanied by his son. He complained that he had undergone prostate puncture at a local hospital more than 3 months ago due to an increased PSA. surgical treatment. Therefore, after using goserelin acetate extended-release implant for 3 months in January this year and taking bicalutamide capsules regularly for anti-androgen therapy, the patient and his family now came to our hospital for prostate surgery, and was admitted to our department as an outpatient with prostate pain, the cause of which is to be investigated.
II. Treatment history
After admission to the hospital, a specialist examination was performed, and the prostate was palpable in the direction of 3-6 points, about 7 cm from the anal verge, with normal size, toughness, mobility, no tenderness, no obvious nodules, and no bleeding in the retreating finger. The patient’s MRI was completed and its findings suggested that the prostate was not large in volume, the peripheral zone and migratory zone were poorly demarcated, the T2 signal was reduced, multiple high signals were seen in DWI, some ADCs were hypo, and the enhancement was not uniformly reinforcing; the bladder and bilateral seminal vesicle glands did not show significant abnormalities in size and morphology signals; the pelvic wall did not show significant abnormalities. After synthesizing the patient’s personal situation and communicating with the patient and his family, laparoscopic radical prostate cancer surgery was chosen to be performed, during which the cancerous tissue was removed and its pathology was examined. Postoperatively, vital signs were closely observed to guard against postoperative complications.
III. Treatment results
The patient had a relatively successful operation and returned to the ward smoothly and safely after the operation with cardiac monitoring. The postoperative recovery was good, with normal urine and drainage fluid, and no abnormal symptoms such as redness, swelling, heat and pain in the incision and urethral opening. Normal diet was gradually resumed after anal discharge 3 days after surgery, and urinary function was gradually restored to normal after the catheter was removed 2 weeks after surgery. At 3 months after surgery, the PSA was rechecked and decreased compared with the preoperative period, indicating that the treatment plan was effective and the disease was under control.
IV. Notes
After 2 weeks of hospitalization, I agreed to discharge the patient. On the occasion of discharge, I reminded the patient and his family that if they found that the pain of the surgical incision was tolerable and there was no other discomfort, they were advised to move off the floor so as to resume exhaustion as soon as possible. And if the surgical incision, redness, swelling, heat and pain, etc., should be promptly visited to the hospital to clarify whether there is any infection. In addition, after discharge from the hospital, it is important to keep urination open and pay attention to personal hygiene. If symptoms such as fever and pain occur, you should also seek medical attention promptly.
V. Personal insight
Prostate cancer is one of the common malignant tumors in elderly men and its incidence is on the rise. Since it has no specific prodromal symptoms, most patients may be diagnosed similar to the patient in this article, who was found to have elevated PSA during the examination. However, at present, after radiotherapy and surgery to remove the lesion, most patients have a better prognosis. Therefore, prostate cancer is not an incurable disease, and those diagnosed should not lose confidence in the treatment, but should actively cooperate with the treatment and establish a correct concept.