Management of Carcinoma prostate with no lymph node or mets in a 72-year-old man is
**Core Concept**
The management of localized prostate cancer (carcinoma prostate) in a 72-year-old man without lymph node or metastatic involvement involves a multidisciplinary approach, taking into account the patient's age, life expectancy, and overall health. The primary goal is to balance the benefits of treatment with the potential risks and side effects.
**Why the Correct Answer is Right**
Active surveillance is a recommended management strategy for localized prostate cancer in patients with a low risk of progression and a favorable life expectancy. This approach involves regular monitoring of the cancer through prostate-specific antigen (PSA) testing, digital rectal examination (DRE), and periodic biopsy. The decision to initiate definitive treatment, such as radical prostatectomy or radiation therapy, is based on the cancer's aggressiveness and the patient's individual risk factors.
**Why Each Wrong Option is Incorrect**
* **Option A:** Radical prostatectomy is a definitive treatment option for localized prostate cancer, but it is not the initial management strategy for a 72-year-old man with a low risk of progression.
* **Option B:** Radiation therapy is an alternative to surgery for localized prostate cancer, but it is not the preferred initial management strategy for a patient with a favorable life expectancy and low risk of progression.
* **Option D:** Hormonal therapy is typically reserved for patients with advanced prostate cancer or those with a high risk of progression, and is not the initial management strategy for a 72-year-old man with localized disease.
**Clinical Pearl / High-Yield Fact**
The American Urological Association (AUA) and the National Comprehensive Cancer Network (NCCN) guidelines recommend active surveillance as a management strategy for patients with low-risk prostate cancer and a favorable life expectancy.
**Correct Answer: C. Active surveillance.**