Skip Metastasis of Prostate Cancer:Diagnosis and Treatment

WANG Jun-qi; LI Wang; WANG Qiang; LIU Kun; MAO Li-jun; CHEN Jia-cun; ZHENG Jun-nian; SUN Xiao-qing

Abstract：Objective:To improve the diagnosis and treatment of far advanced prostate cancer without clinically detectable bone me-tastasis. Methods:Cancer metastatic lesions were found in the liver and lungs respectively of two patients on routine medical exami-nation,and only an abnormally elevated level of the serum prostate specific antigen(PSA)was observed in the following system exami-nations.The patients were diagnosed as having prostate cancer by prostate biopsy.MRI showed a discontinued prostate capsule,and ECT revealed no bone metastasis.Diagnostic treatment was conducted by giving LHRHa combined with antiandrogens.One of the pa-tients underwent surgical castration at 12 months,and both received intensity modulated radiation therapy(80 gy)at 15 and 18 months,respectively. Results:The metastatic lesions in the liver and lungs of the patients were either absent or significantly reduced after treated by maximal androgen blockade for 3 months,and all disappeared after 6 months'treatment,with the PSA level stabilized at less than 0.02μg/L in one patient,and around 0.5μg/L in the other.Antiandrogen treatment was suspended after radiotherapy.The results of liver,lung and bone scanning were normal during the 12-month follow-up,and the PSA level was below 1.0μg/L. Con-clusion:Remote metastasis of prostate cancer may occur in ectosteal organs first,which deserves special attention.A combination of different treatment methods promises satisfactory results.