Multidisciplinary Approach in Prostate Cancer Management: Harmonizing the Role of Surgery, Radiation, and Systemic Therapy

Abstract

Prostate cancer management necessitates a comprehensive multidisciplinary approach, involving specialists such as medical oncologists, urologists, pathologists, radiologist, and radiation oncologists. A 68-year-old male underwent interventions for metastatic prostate cancer. Initially diagnosed with localized disease, he received a radical prostatectomy (RP) and subsequently underwent radiation therapy (RT) along with androgen deprivation therapy (ADT). His initial diagnosis categorized him as high-risk localized prostate cancer (stage cT2cN0M0), guided by screening recommendations, leading to a histopathological diagnosis of pT2N0M0. Prognostic factors like Gleason score and PSA level informed treatment decisions. Although PSA levels initially decreased post-prostatectomy, subsequent rises necessitated further intervention. Early postoperative radiotherapy and adjuvant ADT demonstrated efficacy in improving patient outcomes. Metastatic screening and subsequent therapy were guided by evidence-based protocols. Despite the patient's response to treatment, bone metastasis occurred, prompting palliative external radiation and zoledronic acid therapy. After RP, RT, ADT, palliative external RT, and bisphosphonate therapy, imaging revealed no residual lesions or signs of metastasis, with a significantly decreased PSA level. This case serves as a compelling example of a multidisciplinary team's involvement in maximizing patient care and treatment effectiveness for metastatic prostate cancer.