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Case Reports
. 2018 Apr 18;8(2):e2018011.
doi: 10.4322/acr.2018.011. eCollection 2018 Apr-Jun.

Metastatic castration-resistant prostate cancer and the challenge of a patient with chronic kidney disease in hemodialysis

Joana Simões  1 , Isabel Augusto  1 , Sara Meireles  1 , Lurdes Vendeira  2 , Carlos Silva  3
Affiliations
Case Reports

Metastatic castration-resistant prostate cancer and the challenge of a patient with chronic kidney disease in hemodialysis

Joana Simões et al. Autops Case Rep. .

Abstract

At a time when the population shows increasing longevity, entities such as cancer and chronic kidney disease (CKD) are more frequently connected. In the United States, approximately 6% of the patients on hemodialysis have cancer. The challenge to manage oncologic patients with CKD in a hemodialytic program represents a great shortage of available information on the choice of the best drug, timing, dosage adjustments, dialysis method, and treatment safety. We present the case of a patient with prostate cancer and terminal CKD in hemodialysis, and the treatment sequence after the development of resistance to hormonal blockade therapy, which included docetaxel, enzalutamide, and radium-223.

Keywords: Dialysis; Docetaxel; Enzalutamide; Prostate cancer; Radium-223.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. Bone scans in the last 4 years. Image C corresponds to the bone scan at the time of progression, with new lesions in parietal bone, right scapula, D4-5, 6th to 7th left costal ribs and right iliac.
Figure 2
Figure 2. Bone scan in March 2015. New progression with new lesions at the 8th to 11th costal ribs and right pubis.
Figure 3
Figure 3. Bone scan in December 2016. New progression with new lesions in the 3rd, 6th, 7th, and 11th right costal ribs.
Figure 4
Figure 4. Behavior of the total prostate-specific antigen (tPSA [ng/mL]) and alkaline phosphatase (ALP [U/L]) determinations during and after the treatment with radium-223.
Figure 5
Figure 5. Evolution of bone scans through the years. The image on the right corresponds to the last evaluation, in September 2017, after the end of the treatment with radium-223.
See this image and copyright information in PMC

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