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Final Program


Final Program

Other / General Medicine

1228 - Integrating PM&R in the Management of Spinal Cord and Brain Injury Sequelae of Prostate Cancer Metastasis

Friday, February 20, 2026
5:00 PM - 6:30 PM AST
Case Diagnosis: Prostate Cancer Metastasis Resulting in Spinal Cord (SCI) and Brain Injury (BI) Sequelae 

Case Description: A 61 year old male with a history of high-grade neuroendocrine metastatic prostate cancer presented to acute care with progressive lower extremity weakness over the course of one week. Initial MRI spine and brain revealed over 100 enhancing nodules concerning for widespread metastasis versus cryptococcosis. Cryptococcus testing was negative, favoring metastatic lesions as the diagnosis.  During acute hospitalization, the patient developed urinary retention and constipation managed with stool softeners and an external urinary catheter by the primary team. Physical Medicine and Rehabilitation (PM&R) was consulted for co-management and post-acute planning. They recommended a structured neurogenic bowel and bladder management, including a daily bowel program and intermittent straight catheterization.  Eventually, the patient was transferred to acute inpatient rehabilitation, where he demonstrated improvements in mobility and independence with activities of daily living. About one month later, he was able to be discharged home with family.   

Discussions: This patient presented with symptoms common in SCI and BI patients, including headache, cognition deficits, weakness, tone changes, and most notably, neurogenic bowel and bladder, that were exacerbated by cancer treatment side effects. Physiatrists are uniquely specialized in these complications affecting daily function and can help bridge the gap between multiple subspeciality groups due to their training in these various disciplines. This perspective can help support these complex patients throughout the entire care curriculum to focus on a whole person recovery.  

Conclusions: Patients with multiple diagnoses will continue to be more common in our aging population as cancer incidence and survival rates rise. As such, PM&R physicians will continue to be an important aspect of these patients’ long term care. Despite these challenges and complexities, this case report shows these patients still have potential to make it back home with appropriate support and therapies.