Ternary cancer comprising prostatic cancer, esophageal cancer, and gastric cardia cancer: a case report and literature review

Abstract

A 61-year-old male patient was admitted to our hospital with frequent urination, urgency, and increased nocturia for more than 3 months, and the symptoms were aggravated for 1 week. Prostate biopsy revealed prostatic adenocarcinoma. After 5 months, the patient developed dysphagia and gastroscopy showed a middle and lower esophageal cancer (squamous cell carcinoma). 12 months later, he returned to the hospital because of dysphagia. He was examined by gastroscopy which showed the cardia to have low-grade adenocarcinoma. The patient was given Casodex + Zoladex endocrine therapy, zoledronic acid inhibiting bone destruction, concurrent chemoradiotherapy, capecitabinen tablets at a dose of 1000 mg bid, 3 cycles of intravenous paclitaxel at 180 mg/d1 plus cisplatin 60 mg/d1-2, 4 cycles of intravenous paclitaxel at 150 mg/d1 plus cisplatin at 60 mg/d1 as systemic chemotherapy. The curative effect is was considerable after treatment, and the patient's condition was stable. Since the onset of the disease in March 2018, the patient's condition had not progressed significantly for 27 months. The diagnosis and treatment of this patient with ternary cancer in the hospital improved the clinician's understanding of multiple primary cancers. Multidisciplinary treatment improved the patient's prognosis and quality of life. We reviewed similar case reports and retrospective studies of multiple primary cancers and found that there is no specific treatment for multiple primary cancers, but a corresponding treatment program can be formulated for each tumor to control progression while screening for possible other primary tumors.

Keywords: Ternary cancer; cardiac cancer; esophageal cancer; multidisciplinary treatment; prostatic adenocarcinoma; quality of life.

Figure 1

Prostatic adenocarcinoma (10×10).

Figure 2

Esophageal squamous cell carcinoma (10×10).

Figure 3

Gastric cardiac low-grade adenocarcinoma (10×10).

Figure 4

Levels of TPSA and FPSA.

Figure 5

Levels of CA125, CA199, CEA, SCC-Ag.