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| Physical Exam | 06/06/XX |
54 year old man had trouble urinating for several months. Rectal: Enlarged, hard asymmetrical prostate, with nodule present in right lobe. |
| X-Rays & Scans | 07/01/XX |
Pelvic CT scan: Negative for mets. |
| 07/06/XX | Bone scan: No mets; arthritis only. | |
| Scopes | See surgical findings. | |
| Laboratory | 06/06/XX |
PSA 58.0 |
| Surgical Findings | 06/06/XX |
Cystourethroscopy and TURP: Tumor extended from the anterior lobe of the prostate and extended to the bladder neck and bladder wall; also extended all the way out to the verumontanum. There is concern for capsular involvement. Radical retropubic prostatectomy not advised due to severe respiratory disease. |
| Pathological Reports | 06/06/XX |
Gross: Biopsies of bladder neck, bladder wall, and prostate. Micro: Extensive poorly diff adenoca, Gleason 4+4 = 8 of the prostate gland; also involves the bladder neck and the bladder wall. |
| Treatment | 06/06/XX |
TURP. |
| 07/20/XX | Hormone: Lupron injection | |
| 09/01/XX | Radiation: Beam radiation to prostate and seminal vesicles 4500 cGy 5 field IMRT 6MV, boost to prostate 3060 cGy 5 field IMRT 6MV | |
