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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Glossary
- HEMATOCHEZIA
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Bright red blood in the stool
- INTENSITY-MODULATED RADIATION THERAPY (IMRT)
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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
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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