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Local treatment with radiotherapy
Have seen this twice. Both patients received ADT+RT to lesion. Both expired in less than 4 months. Must be an indicator of extensive disease.
He received local RT to the penis and was started on ADT at the time of diagnosis (July 2012). It was discussed that he should stay on ADT indefinitely. He has continued voiding without difficulty, pain has been minimal, and has maintained a low PSA to this day, now over 2 years after his penile RT.
I have a similar case currently on admission in our hospital. He is 74y old. He had XRT to prostate for T3bN0M0 Gleason Score 4+4 disease in 2006 followed by cryotherapy due to failure of primary treatment 18 months later. All these were carried out at another hospital north of the country. He was not on any hormone therapy when he relocated to our catchment area 7 years ago. Currently on Degarelix (Firmagon) and his PSA 2.3. Testosterone is at castrate level <0.1. He is experiencing great penile pain. Cystoscopy tonight showed infiltration into membranous and bulbar urethra. I would be grateful for any helpful suggestions about what to do next to relieve this patient's penile pain. Thank you. John
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