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How can my father’s urinary incontinence be treated?

Q: My 71 years old was detected with carcinoma Prostrate T-4 last year . He underwent orchetectomy at AIIMS two months after the diagnosis. He later underwent TURP at Batra Hospital and was put on Bondrate by a Urologist. Finally later last year, he went back to AIIMS and they started with chemotherapy, which lasted for 6 rounds. During the procedure, his PSA came down from 151 to 101. He has severe oedema in both the legs which has now come till the scrotum area. Moreover he is not able to control his urine and passes it on the bed. The Urologist at AIIMS recommended not doing reconstructive TURP and put him on medicine Phlogam. What should be his further treatment?

A:According to the description, your father most likely has metastatic hormone refractory prostate cancer. He did receive chemotherapy with only partial response. It’s a difficult situation as far as further treatment is concerned. I am not sure what kind of chemotherapy he received but one option is to enrol him in a clinical trial for new treatment regimen if he fulfils the inclusion criteria.

Obviously you have to contact Urology or Oncology department of a teaching institution for this. Recently, a new vaccine called Provenge was approved in US for the treatment of advanced prostate cancer. It trains body’s own immune system to fight the disease. Regarding the incontinence of urine, he should be examined by the urologist to find out the exact cause (overflow or urge incontinence) and treatment will depend on the type of incontinence.

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