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Localized Prostate Cancer

Posted by iskanbasal on January 2, 2008

A 68-year-old man presents with newly diagnosed prostate cancer. Over the past 3 years, his serum prostate-specific antigen (PSA) level has been slowly and steadily increasing (from 4.0 ng per milliliter to 4.3 ng per milliliter to 4.7 ng per milliliter). His digital rectal examination is normal; the prostate volume, estimated by means of ultrasonography, is 48 ml, and a needle-biopsy specimen reveals an adenocarcinoma with a Gleason score of 6 (the sum of the numbers associated with the most common and second most common histologic patterns — in this case, 3 plus 3). The adenocarcinoma involves 10% of 1 of the 12 cores. The patient otherwise is well, is taking no medication, and has normal sexual function. How should his case be managed?

It is the theme of the last audioarticle from the NEJM.

Listen to the audioarticle.


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