Review Note
Last Update: 02/18/2024 05:30 AM
Current Deck: Part 2::6. High Yield Questions::Genitourinary
PublishedCurrently Published Content
Front
Discuss the factors that you would take into account when
considering a patient for
local salvage treatmentBack
Patient
– is the patient a potential candidate for local therapy
·
Life expectancy
>10years
· EOG 0/1
·
Co-morbidities
·
Urinary function
·
Bowel function
Tumour
·
PSA level (when PSA>4, extra pelvic mets are common. Pre salvage PSA<0.5 improves DMDS and CSM), PSA doubling time.
·
Initial staging (T1-2
better prognosis)
·
Current location and size
of recurrence
·
Restaging with MRI –
extent of recurrence – extra capsular extension or seminal vesicle invasion. Is
there invasion into surrounding organs such as rectum or bladder.
·
Restaging with PSMA PET –
evidence of regional or distant metastasis
Treatment
·
Availability of prostate
brachytherapy
·
Surgical expertise for
local salvage surgery
·
Resources available for
SBRT
·
Other options include
cryotherapy or HIFU (High intensity focused ultrasound) or cryotherapy
Further information, not for memorising (no card)
Exam
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