Yi Qing Tey1, Kavimalar Ravi1, Choon Seng Chong2, Edmund Chiong3, Jingshan Ho4, Jeremy Chee Seong Tey5, Francis Ho5. 1. Yong Loo Lin School of Medicine, National University of Singapore (NUS). 2. Department of Surgical Oncology (Colorectal Surgery). 3. Department of Surgical Oncology (Urology). 4. Department of Haematology-Oncology. 5. Department of Radiation Oncology, National University Cancer Institute, Singapore (NCIS), National University Health Systems (NUHS), Singapore.
Abstract
INTRODUCTION: Synchronous colorectal and prostate malignancies are uncommon, with standard treatment guidelines not yet established. Chemoradiation therapy is involved in both colorectal and prostate cancers. However, differing dosage regimens and effects of irradiation field on anatomical planes for surgery makes management of the synchronous cancers challenging. We report the first case of synchronous prostate and rectal cancer being treated with a combination of treatment modalities with a unique addition of high dose rate prostate brachytherapy boost. PATIENT CONCERNS: The patient, a 69-year-old Chinese gentleman, presented with per-rectal bleeding with alternating bowel habits and a hemoglobin drop. He also had a history of urinary urge incontinence. DIAGNOSIS: Following diagnostic workup, he was diagnosed with synchronous rectal adenocarcinoma (T3N1M0) and prostate malignancy (T2bN0M0). INTERVENTIONS: The management consisted of neoadjuvant androgen deprivation therapy (ADT) and pelvic chemoradiation, followed by high dose rate prostate brachytherapy boost and subsequently anterior resection. OUTCOMES: Following therapy, the patient has no evidence of local recurrence or distant metastasis. CONCLUSION: We suggest a new feasible treatment strategy for the management of synchronous colorectal and prostate cancers.
INTRODUCTION: Synchronous colorectal and prostate malignancies are uncommon, with standard treatment guidelines not yet established. Chemoradiation therapy is involved in both colorectal and prostate cancers. However, differing dosage regimens and effects of irradiation field on anatomical planes for surgery makes management of the synchronous cancers challenging. We report the first case of synchronous prostate and rectal cancer being treated with a combination of treatment modalities with a unique addition of high dose rate prostate brachytherapy boost. PATIENT CONCERNS: The patient, a 69-year-old Chinese gentleman, presented with per-rectal bleeding with alternating bowel habits and a hemoglobin drop. He also had a history of urinary urge incontinence. DIAGNOSIS: Following diagnostic workup, he was diagnosed with synchronous rectal adenocarcinoma (T3N1M0) and prostate malignancy (T2bN0M0). INTERVENTIONS: The management consisted of neoadjuvant androgen deprivation therapy (ADT) and pelvic chemoradiation, followed by high dose rate prostate brachytherapy boost and subsequently anterior resection. OUTCOMES: Following therapy, the patient has no evidence of local recurrence or distant metastasis. CONCLUSION: We suggest a new feasible treatment strategy for the management of synchronous colorectal and prostate cancers.
Authors: Giuseppe Celentano; Massimiliano Creta; Luigi Napolitano; Marco Abate; Roberto La Rocca; Marco Capece; Claudia Mirone; Simone Morra; Francesco Di Bello; Luigi Cirillo; Francesco Mangiapia; Gianluigi Califano; Claudia Collà Ruvolo; Caterina Sagnelli; Antonello Sica; Armando Calogero; Fabrizio Iacono; Ferdinando Fusco; Vincenzo Mirone; Nicola Longo Journal: Diagnostics (Basel) Date: 2022-06-15