Medical Council of Canada MCCQE Part 1 MCCQE Question # 67 Topic 7 Discussion
MCCQE Exam Topic 7 Question 67 Discussion:
Question #: 67
Topic #: 7
You are evaluating a 75-year-old man with recently diagnosed prostate cancer and 2 painful metastases of the lumbar spine. Which one of the following therapeutic options is the most appropriate?
A.
Intrathecal steroid injection
B.
Surgical castration (orchidectomy)
C.
Oral anti-androgen plus gonadotropin-releasing hormone agonist
Palliative radiotherapy is the treatment of choice for painful bone metastases, including those from prostate cancer. It provides localized pain relief and functional improvement.
Toronto Notes 2023 – Oncology, “Metastatic Bone Pain”:
“External beam radiotherapy is first-line treatment for localized bone pain from metastases. Relief occurs within days to weeks.”
MCCQE1 Objectives (Internal Medicine > Oncology > 52-1):
“Candidates must identify treatment options for symptom control in metastatic cancer, including palliative radiotherapy for painful bone lesions.”
Androgen deprivation therapy (B, C) treats systemic disease but doesn’t address acute pain. Opioids (D) may be used, but radiotherapy provides disease-targeted relief. Intrathecal steroids (A) are not standard for prostate metastases.
Chosen Answer:
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