1. www.drsarma.in EACH PATIENT - AN OPEN BOOK Interesting Clinical Cases Dr. R.V.S.N.Sarma., M.D., M.Sc., (Canada) 5 Jayanagar, Tiruvallur 602 001 Mobile 93805 21221 Visit us at : www.drsarma.inwww.drsarma.in

2. Clinical Problem Elderly man of 70 years Ref by our friend for Chronic anaemia Symptoms of urinary tract infection Symptoms of CCF due to aneamia What was wrong ? How he was investigated ? What was the outcome ?

30. www.drsarma.in So, where are we with this case ? Elderly man of 70 years Nutritional aneamia is corrected Prostatomegaly - ? Malignancy - FU He doesn’t want surgery Decided to manage medically Dr. Velu takes over from here on Patient is happy – because no operation Sorry because – he has problem, spent money What will be his prognosis ?

31. www.drsarma.in What is the lesson Any Elderly with aneamia Consider malignancy seriously Evaluate the cause of anaemia There is no use in trying to fill a leaking pot Plug the hole – treat the underlying cause

32. www.drsarma.in About Ca Prostate Third most Ca in men; after lung and colon Rare before 50 years 95% are adenocarcinomas – very slow growing Squamous, transitional cell and carcino-sarcomas DRE – Nodularity, PSA > 10, TRUS and biopsy Androgen deprivation, LHRH antagonists Surgery, Radiation, Chemotherapy