An 80-year-old man presented to the urology clinic with complaints of difficulty urinating and intermittent blood in his urine over the past few months. He also reported increased frequency of urination, especially at night, and a sense of urgency that sometimes led to accidental leakage. Additionally, he had experienced some pelvic discomfort and lower back pain that he attributed to his arthritis but noted it was more persistent than usual.
The patient had a medical history significant for hypertension and benign prostatic hyperplasia (BPH). He was a retired school teacher and lived alone, with occasional visits from his daughter. He denied any significant weight loss, but he reported feeling more fatigued than he had in the past. During the physical examination, the physician noted a firm and enlarged prostate on digital rectal examination (DRE). A serum prostate-specific antigen (PSA) test was ordered, which returned elevated levels. A subsequent transrectal ultrasound-guided biopsy confirmed the diagnosis of prostate cancer, with a Gleason score of 7.
After discussing the diagnosis and the stage of the cancer, the urologist presented treatment options, including active surveillance, radiation therapy, and hormone
therapy. Given the patient’s age and overall health status, the patient opted for radiation therapy to manage the cancer while addressing the urinary symptoms. The urologist referred him to an oncologist for further management and scheduled regular follow-up appointments to monitor his condition and treatment response.