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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 42836
Experience:  Board Certified Physician
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Dear Doctors, i just returned from Home having visited my dad

Customer Question

Dear Doctors, i just returned from Home having visited my dad who was recently diagnosed of prostate cancer. The urologist recommended hormonal therapy which has been successfully completed. The prostate was detected late as he now suffers paraplegies with loss of sensation on bladder and bowel organs. Please advise
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 2 years ago.
Hello
What is your question here exactly?
Customer: replied 2 years ago.

I want to know treatment option for paraplegia.

Expert:  Dr. Thomas, MD replied 2 years ago.
First of all, what do you mean exactly by paraplegia. This normally means he is paralyzed from the waste down. Is this the case?
Customer: replied 2 years ago.

Yes Doctor he has been paralyzed for about two weeks now. the urologist said it was as a result of his prostate cancer. He had his organs removed but said he might not walk again. I am seeking a second opinion regarding treatment options

Expert:  Dr. Thomas, MD replied 2 years ago.
The paralysis would be if the cancer went into the spine at the lower level.

Unfortunately, this is not generally reversible.
They they not tell you this?
Customer: replied 2 years ago.

Yes that was what the urologist said. What i want to know is treatment option for this medical condition

Expert:  Dr. Thomas, MD replied 2 years ago.
Physical therapy.

There is no further treatment for the cancer at this point, unless it becomes active again, then chemotherapy.

Use reply to let me know if you have further questions.
Please to not forget a positive rating.
Customer: replied 2 years ago.

Please can you explain what you mean by physical therapy. I did state on my earlier post that he had his organs removed to stop further spread of teh cancer

Expert:  Dr. Thomas, MD replied 2 years ago.
This is therapy to get his limbs in shape, and he will have to to a lot of upper arm training. It can start at the bedside, then even follow him into the home.

Physical therapists are specialists.

Use reply to let me know if you have further questions.
Please to not forget a positive rating.
Expert:  Dr. David replied 2 years ago.
This is Dr. David

I am a cancer doctor

if he has paralysis from cancer spread to the spine, this is a spinal cord compression.

he needs radiation therapy to the area of the spinal cord where the cancer is pressing on the spinal cord.

physical therapy is not the answers to his paralysis.
Expert:  Dr. David replied 2 years ago.

This is Dr. David

 

physical therapy is not the treatment for paralysis caused by prostate cancer spread to the spine causing paralysis.

 

this is called a spinal cord compression and radiation therapy and steroid therapy are needed for this.

 

 

you need to get your father to see a radiation oncology doctor as soon as possible

 

and high dose dexamethasone steroid therapy are needed as soon as possible to decrease swelling to the spinal cord.

 

this is a cancer emergency when cancer causes paralysis like this.

 

and needs to be treated right away with radiation therapy.

Customer: replied 2 years ago.

Dear Dr. David.

 

below is the summary of pathologist report..

 

Macroscopy.. Specimen consists of multiple large greyish white tissue cores, all of which were processed.

Microscopy... Section show a malignant and infiltrative lesion composed of atypical densely staining epithelial cells with hyperchromatic nuceli forming mainly architecturally malignant glands devoid of myoepithelial cell linings wit some areas showing cribriform of sheet-like patterns wit poor gland formation while invading the surrounding tissues

 

Diagnosis..poorly differentiated invasive adenocarcinoma of the prostate/ gleason score 4 + 3 = 7.

 

I hope this can you further understand the condition

Expert:  Dr. David replied 2 years ago.
This is Dr. David

yes, I understand the condition very well

I am a cancer doctor who treats men who have metastatic prostate cancer spread to bone.

the gleason score is how abnormal the cancer cells look under the microscope. but does not tell us anything about where his cancer has spread to.

hormone therapy is a shot of medication like leuprolide or goserelin which tricks the pituitary gland to stop making LH and FSH and his testicles stop making testosterone.

this starves and freezes all of the prostate cancer in the body, but does not kill prostate cancer cells.

prostate cancer often travel and spread to bones of the spine which is close to the spinal cord.

and so when the cancer grows large enough, it can grow and press on nerves in the spinal canal. this can cause paralysis of the legs, loss of sensation, loss of urinary control (urinary retention, and then urinary overflow) and also loss of anal control and loss of anal sphincter tone and sensation.

this is called a spinal cord compression

I know radiation therapy machines are rare in Nigera. He might have to travel to a larger city to see a cancer doctor where he can get radiation therapy delivered to the spine where the cancer is pressing on his spinal cord.

here is an article about radiation centers in Nigeria

http://www.wajradiology.org/article.asp?issn=1115-1474;year=2013;volume=20;issue=1;spage=30;epage=36;aulast=Adewuyi

here is a list of the centers where you can go

http://www.wajradiology.org/viewimage.asp?img=WestAfrJRadiol_2013_20_1_30_117909_b1.jpg

let me know if you have questions.
Customer: replied 2 years ago.

Dear Dr. David,

 

Many thanks for the insightful information. I have gained proper enlightenment based on the information provided. Please be patient with me as just troubled by the fact that i have a father who lies helplessly with no information regarding his condition.

 

Kindly shed more light on this sentence ''and so when the cancer grows large enough, it can grow and press on nerves in the spinal canal''

 

I was made to understand that cancer had eaten away his nerves and it is irreversible. By pressing do you mean there is hope of his regaining his movement?

 

 

Expert:  Dr. David replied 2 years ago.
How long he's paralyzed makes a difference whether or not his paralysis is reversible or not

That's why it is such an urgency to get patients treated with paralysis as soon as possible.

If he's been paralyzed on for a few weeks then there is a chance his paralysis could be reversed with radiation therapy.

If he is paralyzed a few months or longer then the chance of reversing the paralysis by shrinking the cancer with radiation is little to none.
Expert:  Dr. David replied 2 years ago.
let me know if you have other questions.

if done for now, please click accept and leave positive rating below the chat box so I can get credit for helping you today

you can always reach me with "a question for Dr. David" if you have any other questions

here is my website

http://www.justanswer.com/medical/expert-dr-david/

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