Case 2

Introduction
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Peter, a 73 year old Dutch man, was diagnosed with prostate cancer soon after marrying for the second time. He underwent a TURP and had localised radiotherapy to his prostate area. Peter has a past history of hypertension.

Peter and his second wife Kate live on a large property in a semi rural area. They enjoy gardening and bush walking. Peter’s first wife died of a cerebrovascular accident and Kate’s first husband died of stomach cancer.

Four years after his original diagnosis of prostate cancer, Peter presents with moderately severe abdominal pain, which is fully investigated in hospital. A CT scan reveals secondaries in several pelvic lymph nodes. A bilateral orchidectomy is performed and he is referred to a radiation oncologist for review. Peter consults you for the first time after learning of your special interest in counselling and palliative care. You discuss his feelings about the recurrence and give supportive counselling. Following your suggestion he attends a cancer support group.

Peter remains optimistic about his condition until he is reviewed by his oncologist several weeks after undergoing the bilateral orchidectomy.

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