Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 27516
  Title Presumptive prostate cancer presenting as low back pain in the chiropractic office: Two cases and literature review [case study]
Journal Asia-Pac Chiropr J. 2023 Apr;3(4):11
Peer Review Yes
Publication Type Case Report

Abstract: Prostate cancer is a common type of cancer in men and may metastasise to the spine and pelvis, causing back and/or radicular pain that appears to be musculoskeletal. This presents a diagnostic challenge and can be complicated by a lack of routine screening for prostate cancer.

In two similar cases, elderly males (ages 78 and 82) with no known history of cancer and no previous prostate-specific antigen screening presented to a chiropractor with chronic, worsening radiating low back pain. In each case, a previous provider obtained radiographs and ascribed symptoms to a non-cancerous aetiology (i.e., lumbar spondylosis, osteoporotic compression fracture), treated with nonsteroidal anti- inflammatory medications and physiotherapy. Given each patient’s progressive worsening and neurologic deficits, the chiropractor ordered lumbar
magnetic resonance imaging, revealing potential spinal metastasis. The chiropractor referred each patient to an oncologist who performed additional testing, making a presumptive diagnosis of prostate cancer. A literature review identified seven cases of previously undiagnosed prostate cancer presenting to a chiropractor. Including the current cases, patients were often older, presenting with thoracolumbar pain caused by spine or pelvic metastasis.

The current cases and literature review illustrate that men with undiagnosed metastasis from prostate cancer may present to chiropractors complaining of spinal pain. Chiropractors should be aware of red flags warranting imaging such as older age and new or progressive symptoms and should refer patients to an oncologist when suspecting prostate cancer. 
Author keywords: Chiropractic - Men's health - Aged - Neoplasm metastasis - Low back pain - Prostatic neoplasms

This abstract is reproduced with the permission of the publisher; click on the above link for free full text. Online access only.


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