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  • Case Study
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Multidisciplinary treatment of synchronous primary rectal and prostate cancers

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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Correspondence to Athanasios Colonias.

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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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