scholarly journals Prostate Artery Embolisation as a Palliative Care in a Patient with Prostate Cancer: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
R. B. Nerli ◽  
R. B. Nerli ◽  
Priyabrata Adhikari ◽  
Naveen Mulimani ◽  
Saziya Bidi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Maximum Flow ◽  
Artery Embolization ◽  
Serious Adverse Events ◽  
Arterial Access ◽  
Prostate Artery Embolization ◽  
Femoral Arterial Access ◽  
Castrate Resistant ◽  
Prostatic Gland

Introduction: Prostate artery embolization is an emerging technique, that appears to be a promising option in the management of benign prostatic hyperplasia for patients unsuitable for surgery. Prostate artery embolization, similar to all other interventions, is not a suitable treatment for all patients with this disease. It is indicated as a minimally invasive option in patients unfit to undergo trans urethral resection of prostate. Case Report: A 78-year-old male suffering from castrate resistant prostate cancer and on treatment with Abiraterone plus prednisolone presented to the Uro-oncological services of the hospital with difficulty to void, incomplete voiding, and sense of incomplete voiding. He had other medical co-morbidities which included Diabetes mellitus, hypertension, and ischaemic heart disease. His cardiac ejection fraction was 25% and was advised not to undergo any surgical procedure. Serum creatinine on admission was 2.2 mg% and serum PSA were 26.5 ng/ml. Under local anaesthesia, using retrograde Seldinger’s technique right common femoral arterial access was obtained and 6F vascular introducer sheath was placed. Bilateral pelvic angiogram was performed, each of the prostatic arteries was superselectively catheterized and the prostatic gland was embolized using PVA (polyvinyl alcohol) particles 200m. Post catheter removal the patient voided well with a maximum flow of 14.5 ml/sec. Conclusion: Prostate artery embolization can successfully treat complications associated with prostate cancer such as LUTS, urinary retention and haematuria with a low risk of serious adverse events.

scholarly journals A proof-of-concept study on the use of prostate artery embolization prior to definitive radiotherapy in prostate cancer

2020 ◽  
Author(s):  
Jeffrey Peacock ◽  
Dhiraj Sikaria ◽  
Laura Maun-Garcia ◽  
Khosrow Javedan ◽  
Kosj Yamoah ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Treatment ◽  
Organs At Risk ◽  
Statistical Significance ◽  
Volume Reduction ◽  
Proof Of Concept ◽  
Artery Embolization ◽  
Definitive Radiotherapy ◽  
Prostate Artery Embolization

Abstract Backgrounds: Prostatic artery embolization (PAE) has been well studied as a clinically effective therapy for alleviating lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH). We demonstrate a proof of concept for PAE prior to definitive radiotherapy in patients with prostate cancer.Methods: From 12/2017 to 07/2019, 57 patients underwent PAE for LUTS and BPH. Nine of these patients had PAE for LUTS in the setting of localized prostate cancer prior to receiving radiation. Five of the nine patients received their entire radiotherapy course at our institution and had clinical follow up were included in the analysis. Median follow up was 18 months from the time of PAE. LUTS improvement quantified by IPSS was the primary endpoint and a two tail students T test was used to compare statistical significance. Side effects during radiation were quantified using the CTCAE scoring system. Pre- and post- PAE plans were compared in the five patients that by performing an isovolumetric expansion of the post PAE plan (treated plan) equivalent to the measured volume reduction after PAE. Patient 1 and 2 had prostate and seminal vesicle RT alone while patients 3-5 had prostate with elective nodal coverage. Mean doses to organs at risk were compared between the two plans.Results: The average IPSS score pre-PAE was 17.40 compared to post-PAE of 3.6 (p=0.02). The average IPSS score reduction after PAE was 13.8 (5-30). The average prostatic volume reduction after PAE was 23.14% (7.2% - 47.7%). There were no CTCAE grade 3 (severe) or higher during radiation treatment. Post-PAE plans in patient 1 and 2 had on average 16.7% and 39.8% decrease in mean dose across the bladder, rectum, and penile bulb compared to the pre-PAE plans. There were no appreciable differences in dosimetry in the patients 3-5 who had nodal coverage. There was no biochemical failure in any of the patients.Conclusion: We demonstrate a proof of concept that prostate artery embolization is useful as an adjunctive procedure to alleviate LUTS, achieve significant volume reduction prior to radiation therapy, and decrease radiation related toxicity in the treatment of prostate cancer.

Prostate Artery Embolization via Transradial or Transulnar versus Transfemoral Arterial Access: Technical Results

2017 ◽  
Vol 28 (6) ◽  
pp. 898-905 ◽  
Author(s):  
Shivank Bhatia ◽  
Sardis H. Harward ◽  
Vishal K. Sinha ◽  
Govindarajan Narayanan
Keyword(s):  
Artery Embolization ◽  
Arterial Access ◽  
Prostate Artery Embolization

scholarly journals Polyneuropathic Pain Th erapy with a Patient Suffering from Generalized Castrate- Resistant Prostate Cancer – Clinical Case Report

2013 ◽  
Vol 26 (5) ◽  
pp. 354-357 ◽  
Author(s):  
Luboš Holubec ◽  
Pavla Mrázková ◽  
Vít Martin Matějka ◽  
Ondřej Fiala ◽  
Jindřich Fínek
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Clinical Case ◽  
Castrate Resistant Prostate Cancer ◽  
Castrate Resistant

scholarly journals Prostatic artery embolization (PAE) for prostatic origin bleeding in the context of prostate malignancy

2019 ◽  
Vol 8 (6) ◽  
pp. 205846011984606 ◽  
Author(s):  
Charles R Tapping ◽  
Jeremy Crew ◽  
Andrew Proteroe ◽  
Phil Boardman
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Benign Prostatic Hypertrophy ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Prostate Artery Embolization ◽  
Prostatic Artery

Prostate artery embolization (PAE) has been shown to be beneficial in treating men with benign prostatic hypertrophy (BPH). Here we describe treating four patients with prostate cancer (two with organ-confined and two with metastatic prostate cancer) with prostatic bleeding with PAE. Patients had other causes of hematuria excluded and were followed up at 3, 12, and 18 months after PAE. All four cases were technically successful and all cases of hematuria had resolved by the three-month follow-up (100%). There was one case of recurrence at 13 months after PAE which was successfully treated. PAE is useful for controlling significant prostatic bleeding in patients with prostate cancer and improves quality of life. Patients may, however, need repeated treatments to control the bleeding.

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