A 65 year old male presents with CA prostate. The tumour is limited to the capsule and it is palpable on PR examination. The patient is diagnosed as stage T1b. The best treatment would be -

Ans. is 'a' i.e., Radical prostatectomy Treatment plan for Ca prostateA. T1 a disease# These tumors found incidentally at TURP is by the definition low volume (< 5%) and usually well differentiated and associated with very slow growth rate.# They are managed by active survelliance (regular follow up is done by DRE & PSA), considering treatment if there is disease progression.B. Tib, T1c & T2 disease# Management depends on patient's age, life expectancy, performance status, and patient's preferences# In younger, fitter men (< 70 yrs), ds. may be treated by radical prostatectomy or radical radiotherapy.# Watchful waiting is an option for elderly with low life expectancy (<10 yrs). Even younger patients may choose watchful waiting when counselled about risk versus benefit.C. Advanced ds (T3, T4 or any metastasis)# Only palliative tit is the option1. Androgen ablation is the first line therapy# it can be achieved bya) Orchiectomyorb) Drugs (medical castration)2. Palliative radiotherapy