Men with advanced prostate cancer who develop an adrenal tumor will usually undergo laparoscopic adrenalectomy (removal of the adrenal gland) as a treatment method. Just like with prostate surgery. in some situations surgery might not be the best alternative for an individual man.

An individual case was recently completed at the Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan using real-time tracking radiotherapy (RTRT) with a gold marker. This procedure was similar to the prostate radiation treatments some of us have had using gold markers. RTRT is considered one of the possible treatment options to surgery because this system can reduce the adverse effects of organ movement such as that in the adrenal gland or kidney.

A 64-year-old man with hormone refractory advanced prostate cancer with an isolated adrenal metastasis in his adrenal gland was the subject. The man underwent RTRT treatment with an implanted gold marker in the right adrenal metastasis. He experienced no adverse events from the procedure. Even though his prostate cancer did progress, experiencing an elevated prostate-specific antigen (PSA) 8 months post the RTRT treatment, there was no further growth of the right adrenal metastasis before he died.

Conclusion: Even though this study had only one man involved, until further similar studies can replicate the results, RTRT treatment with an implanted gold marker might be feasible for the treatment of isolated adrenal metastasis from malignancies including prostate cancer.

Int J Urol. 2009 Apr;16(4):410-2.
doi:10.1111/j.1442-2042.2008.02230.x, Sazawa A, Shinohara N, Harabayashi T, Abe T, Shirato H, Nonomura K.
PubMed Abstract

Joel T Nowak MA, MSW