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Question
Hello, my father is 90 years old, he recently had a turp surgery, he had used a catheter for several months. After the surgery he was able to go without the catheter. The only problem is that the urologist found a small amount of rare cancer cells in the urinay track I guess.
They gave him scans to make sure it had not spread. It had not.
The Dr called it High Grade Neuroendocrine carcinoma I believe.
He said in his opinion the best option at this time is to repeat the trup surgery and try to get all the cancer cells,if I understood him correctly. Do you think this is a reasonable option ? We live in a small town and have a limited number of funds.
Thank You.
Doug.

Answer
Doug:

Neuroendocrine tumors of the prostate are quite rare, comprising only about 1% of all prostate cancers.  They are high grade and usually do not respond to traditional prostate chemotherapy or radaton but they will respond somewhat to other types of chemotherapy.  

A repeat TURP is very reasonable given this diagnosis with the idea being to remove all the prostate tissue possible.  At the same time, you also have to consider overall quality of life and how much additional treatment to provide to a 90 year old man.  This will depend on his overall health and performance status.

In most cases of neuroendocrine ca of the prostate, the prognosis is unfortunately not too good with most patients living only a year or less.  However, prostate cancers are less aggressive in 90 year old men and there was only a very small area involved so perhaps it's been or will be totally surgically removed.  I've copied a link to a good article on this tumor.  Good luck.


http://emedicine.medscape.com/article/1611899-overview#a1

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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