Paraplegia and prostatic cancer

When paraplegia occurs as a result of malignant disease, it generally means that the patient's survival is limited to a few months. The exceptions to this rule include patients with paraplegia or quadraplegia as a result of metastases from carcinoma of the prostate. This study concerns 24 men with paraplegia, 20 of whom lived for over 5 years following the onset of paralysis, 18 being rehabilitated. The prostatic cause of paralysis may not be obvious at the first, and conventional X-rays of the spine may be negative. The serum acid phosphatase was raised in several cases, confirmation of the diagnosis could either be made by biopsy of the prostate gland or, if laminectomy is performed, by examining the tissue that compresses the spinal cord. Laminectomy is recommended only in patients with rapidly advancing neurological signs. The treatment of choice is orchidectomy rather than hormonal treatment in the elderly age group, as oestrogens cause cardio-vascular complications.