Question 1

Question

A 70-year-old man with metastatic castration-resistant prostate cancer presents to the emergency department with severe back pain, bilateral lower extremity weakness (3/5 strength), and urinary retention that started 8 hours ago. He has known bone metastases and his PSA has been rising despite androgen deprivation therapy. MRI spine shows an epidural mass at T10 with severe spinal cord compression and near-complete canal obliteration. He is neurologically intact above T10. Radiation oncology, neurosurgery, and medical oncology are consulted. Evaluate the optimal management approach.

Accepted Answer

Emergent surgical decompression followed by radiation therapy

Answer

Corticosteroids, radiation therapy, and switch to next-line systemic therapy

Answer

Stereotactic radiosurgery as single-modality treatment

Answer

Palliative care consultation and comfort measures only given metastatic disease

Answer

High-dose corticosteroids and emergent radiation therapy alone

Urology Basics — MCQs

Urology Basics — MCQs

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