MINISTRY OF HEALTH CARE AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION

Unit of radiation and surgical treatment of urologic diseases with a group of brachytherapy for prostate cancer

Phone: (48439) 9-30-44

MEDICAL DISCHARGE REPORT No. 3568/12

XXX, born XXX, residing at the address: XXX was admitted to urology unit of RRC from 06/06/12 till 08/06/12. The following examination was carried out:

MRI of the small pelvis organs from 16/04/12: prostate 5.1 × 3.5 × 3.9 cm (36 cm³), in the central regions adenomatous nodosity without intravesical component was registered. In the peripheral zone of both lobes areas of subnormal signal are defined. The seminal vesicles are not changed. Urinary bladder is enough filled, its signal and wall contour are not changed. Ureters are not dilated. Enlarged lymph nodes in the target level were not defined. Areas of pathological MRI signal characteristic for the mts-lesions in the bones included in the study area are not detected. Conclusion: MR-picture of prostate gland T2c cancer.

Histopathologycal report No. G2300/12 from 16/04/12: adenocarcinoma, Gleason grade 6 (3+3), in an one biopsy from the right and an one biopsy from the left lobe.

CT of the chest (the conclusion of another facility) from 01/06/12: CT signs of "fresh" lesions in the organs of the chest are not detected; moderate liposis of anterior mediastinum to the left, local pleurofibrosis in the left front of the diaphragmatic pleura angle.

Blood type: B (III) Rh + positive (from 15/05/12).

Blood analysis from 15/05/12: Ab - HIV-1,2; HBs-antigen, anti-HCV (total): negative.

Uroflowmetry from 06.06.12: peak flowrate 11,3 ml/s.

The following treatment was carried out: surgery 07/06/12 – iodine-125 brachytherapy, time-integrated radiation dosage – 140 Gy.

The patient has endured the treatment satisfactorily.

Treatment: contact radiotherapy (brachytherapy) of prostate cancer with the sources of iodine-125: after a general clinical examination (07/06/12) being carried out, implantation of closed microsources iodine-125under spinal anesthesia was performed in prostate tissue, according to dosimetric planning under the control of helical computed tomography. Total 104 microsources of iodine-125. Number of needles: 31. Total boost dose: 145 Gy. At the time of surgery urethral catheter was inserted.

At the time of discharge condition is satisfactory, urination being self-acting, urine output was sufficient. Monitored (06/08/12): at 1 meter distance a background value (0.24 mSv / h) was detected.

The patient is being discharged in satisfactory condition with recommendations under the supervision of a physician-oncologist in the place of residence.

You may wish:

1.      Suppository Vitaprost Forte during the night for 1 month, suppository with methyluracil o.m. for 1 month.

2.      Omnic Okas × 1 capsule twice a day (morning and evening) for 1 month, followed by 1 capsule at night for 3 months.

3.      Canephron N 2 dragees × three times a day for 1 month.

4.      Zyprinol 500 mg × twice a day for 5 days.

5.      Outpatient visit after 5 weeks.

The  primary certificate of work incapacity was issued under No. 048433055731 (open) for the period from 06/06/2012 till 08/06/2012 and from 09/06/12 till 13/06/12.

DIAGNOSIS: Prostate cancer T2cN0M0.

Comorbidities: ischemic heart disease, angina of effort functional class II, hypertension stage I.

 Head of unit of radiation and surgical treatment of urologic diseases with a group of brachytherapy for prostate cancer, MD, Professor O. B. KARYAKIN <signed>

Attending Physician, Ph.D. in medical sciences A. BIRYUKOV <signed>

<Doctor's personal seal: Vitaly A. Biryukov>