A cancer diagnosis like King Charles’ is not unheard of

A patient is admitted to the hospital to undergo a routine procedure to treat an enlarged prostate.

And, unexpectedly, a test done in hospital – perhaps a blood test or an x-ray or an examination of the urethra and bladder – detects cancer.

Apparently, something like this happened to King Charles III.

When the British monarch was treated for an enlarged prostate in January, doctors found cancer that the palace said It’s not a prostate.

Carlos started treatment on Monday.

The palace did not reveal what led to the king’s diagnosis.

Although some prostate specialists, such as Dr. Peter Albertsen of the University of Connecticut, have called these situations “quite rare” other doctors said were not unheard of.

Dr. Otis Brawley, an oncologist at Johns Hopkins Medical Center in Baltimore, said a man had come in for routine prostate surveillance to monitor for low-risk cancer.

One of Brawley’s residents ordered a chest X-ray “for no reason,” he said.

But to Brawley’s surprise, the x-ray revealed a lung cancer.

Some cancers require immediate treatment, while for others treatment can wait, oncologists said.

The palace did not describe the severity of Carlo’s diagnosis, or the treatment he was receiving.

Some blood cancers are among those in need immediate treatmentBrawley said.

“We have some too leukemias and lymphomas where we want to start therapy less than 24 hours after suspicion,” he said. Brawley doubted that Charles had one of the more aggressive blood cancers, acute myeloid leukemia or Burkett’s lymphoma.

But if I had it, the treatment it would not be postponed.

These are tumors “that we skip over,” Brawley said.

He added: “These are things we start dealing with in the middle of the night if necessary.”

Detection

It is not known whether King’s cancer was discovered while doctors were preparing for the operation, which may have been preceded by something like a blood test, CT scan or MRI.

Doctors can also detect another type of cancer by passing an endoscope through the patient’s urethra during treatment for an enlarged prostate.

Dr. Benjamin Bryer, a urologist at the University of California, San Francisco, noted that if cancer is detected iincidentally into a man’s prostate and it is discovered that it did not originate there, the situation can be serious.

“It is, by definition, a metastasis,” Bryer says.

Among the tumors that can spread to the prostate are melanomas.

A type of bladder cancer known as urothelial carcinoma can also appear in the prostate.

According to Dr. Scott Eggener, a urological oncologist at the University of Chicago, this type of bladder cancer is the most likely of those that do not affect the prostate to be detected as part of treatment for an enlarged prostate.

The inner lining of the bladder has become cancerous and spreads into the urinary tract, he explained.

Cancer can be detected during prostate treatment “when the prostate is scraped from the inside.”

There are two types of this bladder cancer, said Dr. Judd Moul, a urologic oncologist at Duke. One is “more annoying,” he said.

The cancer is removed surgically, and medications are given to the bladder periodically to treat the remaining cells.

The other type, called muscle invasive, is serious.

The treatment consists of complete removal of the bladder.

“We hope and pray that this is not the case,” Moul said.

Usual cases

But by far the most common cancer detected during enlarged prostate treatment is prostate cancer.

Bryer estimates that this occurs in 5% to 10% of cases, although one study found that prostate cancer was detected in 26% of cases of men treated due to enlargement of the prostate.

In King Charles’ case, there is too little information to guess what type of cancer he has or how it was discovered, according to Bryer and others.

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