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Multidisciplinary treatment of synchronous primary rectal and prostate cancers

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From Nature Clinical Practice Oncology

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Abstract

Background A 58-year-old Caucasian man with a history of irritable bowel syndrome and occasional rectal bleeding presented with a 4-week history of progressive, bright red blood per rectum. A digital rectal examination revealed a 3 cm distal, midrectal mass. Laboratory tests showed an elevated serum prostate-specific antigen of 32 ng/ml but other physical and medical examinations were unremarkable.

Investigations Digital rectal examination, colonoscopy, rectal mass biopsy, endorectal ultrasound, transrectal ultrasound-guided prostate biopsy, CT scan and MRI.

Diagnosis Clinical stage III (T3N1M0), moderately differentiated adenocarcinoma of the rectum and clinical stage II (T1cN0M0) adenocarcinoma of the prostate.

Management Intensity-modulated radiation therapy, chemoradiation, chemotherapy, hormone therapy and surgery.

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Figure 1: Pelvic digitally reconstructed images of target tissues with radiation isodose lines are shown.

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Author information

Authors and Affiliations

  1. teaching attending physician at Allegheny General Hospital Department of Radiation Oncology and the West Penn Allegheny Cancer Institute Radiation Oncology Network,

    Athanasios Colonias

  2. postdoctoral radiation oncology resident at Allegheny General Hospital,

    Lloyd Farinash

  3. board certified dosimetrist and board certified radiation therapist,

    Linda Miller

  4. surgeon specialising in colon and rectal surgery at Allegheny General Hospital,

    Sandra Jones

  5. Division of Colon and Rectal Surgery at Allegheny General Hospital,

    David S Medich

  6. Drexel University School of Medicine,

    David S Medich

  7. teaching attending physician in Medical Oncology at Allegheny General Hospital and the West Penn Allegheny Cancer Institute,

    Larisa Greenberg

  8. Allegheny Prostate Center,

    Ralph Miller

  9. Drexel University College of Medicine, Philadelphia, PA, USA

    Ralph Miller

  10. Allegheny General Hospital Department of Radiation Oncology and the West Penn Allegheny Cancer Institute Radiation Oncology Network,

    David S Parda

  11. Drexel University College of Medicine,

    David S Parda

Authors
  1. Athanasios Colonias
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  2. Lloyd Farinash
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  3. Linda Miller
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  4. Sandra Jones
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  5. David S Medich
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  6. Larisa Greenberg
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  7. Ralph Miller
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  8. David S Parda
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Corresponding author

Correspondence to Athanasios Colonias.

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Competing interests

The authors declare no competing financial interests.

Glossary

HEMATOCHEZIA

Bright red blood in the stool

INTENSITY-MODULATED RADIATION THERAPY (IMRT)

An advanced external beam radiation technique using multiple beams of different radiation intensity within a field to produce a radiation dose distribution that is highly conformed to the tumor with sharp dose fall-off to surrounding normal tissues

THERAPEUTIC RATIO

The difference between a minimum therapeutically effective dose and a maximum dose capable of inducing intolerable side effects

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Colonias, A., Farinash, L., Miller, L. et al. Multidisciplinary treatment of synchronous primary rectal and prostate cancers. Nat Rev Clin Oncol 2, 271–274 (2005). https://doi.org/10.1038/ncponc0173

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  • DOI: https://doi.org/10.1038/ncponc0173

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