A pt,age 65 yr, presnted with LUTS, increased frequency, poor urinary stream, intermittency, nocturia. On rectal examination grade 2 prostate with hard nodule in rt lateral lobe, his serum PSA was >100ng/ml. Prostatic bx suggestive of adenocarcinoma Gleason score 4+3=7. What is the next step of management in this case? Should I go for b/l orchidectomy directly or do metastatic workup first?
We can take serum psa >100 as a predictor of metastatic desease. My dout is this, CA prostate pt with low risk or intermediate risk group on the basis of Gleason score and clinical stage but only serum PSA is higher side(>60,70,80,or 100). Thr pt life expectancy is more than 15yr. What is the guideline of management in these types of pts?
