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What is your approach to a patient with prostate cancer with suspicion of rectal wall invasion but otherwise localized disease?
Would you treat this patient any differently than any other very high risk prostate cancer patient? Are there any additional dose constraints for the rectum that should be taken into account?
Answer from: Radiation Oncologist at Community Practice
My approach in a prostate cancer patient with "suspicious" rectal involvement is to verify, in fact, if he has actual rectal involvement, or not and NOT "suspicious" involvement.
I guess my point is that I WOULD BE VERY hesitant to start RT intervention without verifying if the patient had rec...
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Answer from: Radiation Oncologist at Community Practice
I would recommend 3TmpMRI to better characterize local extent of disease. If the patient has clear T4N0 disease, I'd favor giving this patient an extended course of neoadjuvant ADT for 6-9 months with repeat imaging to assess regression. This may be a case where the use of a rectal balloon may be wa...
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Radiation Oncologist at UCF COM
Well said. This case illustrates where the treatin...
Well said. This case illustrates where the treatin...
Answer from: Radiation Oncologist at Academic Institution
Number one point: we should not assume that a note on the prostate MRI report along the lines of "possible rectal wall invasion" means (1) that there is any certainty invasion is present or (2) that invasion is through the wall. Of course, degree of suspicion varies, and there is not one answer for ...