Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of metastatic prostate cancer (C61.1). Current symptoms include [bone pain/urinary obstruction/fatigue/weight loss]. Review of systems positive for [hematuria/nocturia/bone tenderness]. Current ADT therapy status: [ongoing/refractory]. PSA trend: [stable/rising]. ECOG performance status: [0-4].
Clinical Examination Findings
General: Patient appears [well-developed/cachectic]. Abdomen: Soft, non-tender, no palpable masses. Genitourinary: DRE reveals [asymmetric/indurated/fixed] prostate gland with loss of median sulcus. Lymph nodes: No palpable supraclavicular or inguinal lymphadenopathy. Musculoskeletal: Tenderness noted at [lumbar spine/pelvis/ribs] consistent with metastatic deposits. Neurological: Intact, no focal deficits.
Treatment Protocol
Plan: 1. Continue Androgen Deprivation Therapy (ADT) with [LHRH agonist/antagonist]. 2. Initiate/Continue [Abiraterone/Enzalutamide/Docetaxel] as per protocol. 3. Bone-targeted therapy: [Denosumab/Zoledronic acid] to prevent SREs. 4. Pain management: [NSAIDs/Opioids/Palliative radiotherapy]. 5. Monitor PSA, testosterone, and CBC/CMP every [interval].