Problem
Case Study: A 60-year-old male presents to your clinic. He reports urinary frequency and incontinence since having his chemo and radiation therapy three years ago, secondary to prostate cancer. Even though the symptoms are bothersome, he is more concerned about his low back and hip pain which began approximately one month ago, which he initially attributed to lifting heavy boxes. The pain is now constant and disrupts his sleep. Labs reveal a normal urinalysis and CBC, a PSA of 7.2. A DRE reveals an enlarged, nodular prostate. The x-rays of the LS spine are positive for mild degenerative changes and what appears to be a cystic mass near the spine.
When we look at the case study, we know this patient has a history of prostate cancer and has been treated with chemotherapy/XRT. Our patient's PSA is 7.2. Is this high or normal? There is a 90% chance the cancer will go into the bone. What bones are close to the prostate? Think about the male anatomy. Where is the prostate located? What are the risk factors associated with getting prostate cancer? If a patient has frequent prostatitis, are they at a higher risk of getting prostate cancer? What about his treatment plan? Would chemotherapy/XRT or even the cancer itself cause a patient to become anemic?