...crisis visceral a expensas ganglionar además de ósea es virgen a....

[Traductorachilena]

Hola otra vez, amigos y colaboradores del foro!

I think this time I need some help from one of our English native speakers. I'm having quite a hard time trying to understand what they meant in Spanish, let alone figuring out how it translates into English. The wording is not the best and, once again (as in a doc. that I translated recently), I have two lines with no punctuation!

Pero me sería igualmente valiosa la colaboración de un forero hispanohablante, que me ayude a descifrar en español lo que quiso decir el oncólogo en estas dos líneas.

I'm providing a little bit of context, so you can have a better idea of what this is about.
This is a note from an oncologist about a patient who presents bilateral obstructive uropathy, secondary to advanced prostate cancer.

The paragraph starts: "Paciente masculino, joven, con buen estado funcional con cuadro agudo (daño renal) en resolución. Diagnóstico muy probable de cáncer de próstata metastásico EC IV, "muy probable" porque no contamos con biopsia confirmatoria."
I already have this part, maybe the only thing I would like someone to validate -or correct- for me is "good performance status" for "buen estado funcional."

This is what follows and where I need help, please, please!
It says: "El paciente cuenta con actividad metastásica diseminada o crisis visceral a expensas ganglionar además de ósea es virgen a tratamiento oncológico aunque lo habitual sería pensar en tratamiento en base a hormonoterapia."

No punctuation in these two lines ... not even a comma! That is why I just cannot figure out what the oncologist meant here. I'm sorry.

My try: "Patient shows disseminated metastasis or visceral crisis at the expense of ... lymph node metastasis?(=> not sure about this one) as well as bone metastasis ...
That is all I have. I cannot make the connection between ..."a expensas ganglionar además de ósea" ... and "es virgen a tratamiento oncológico..." I wonder if a comma right after "además de ósea," would help ... So this what my face looks like right now.
Nor can I make the connection between... "actividad metastásica diseminada"... and "o crisis visceral" ...

I need:
1) Help to figure out where we can throw a few commas to make sense out of this.
2) Help to figure out what the doctor is saying
3) Help to translate into English the [second] half of the sentence, which I haven't been able to figure out yet.

I will be forever grateful for ANY help I can get!
Thank you so much to all of you out there! I know someone will come to rescue me!
Overwhelmed Angelica

 

[EricEnfermero]

buen estado functional - good functional status

virgen a tratamiento oncológico - virgin to oncologic treatment; in other words, the patient has not received things like chemotherapy or radiation; some sources might refer to this as a "treatment-naïve" patient

Probably a comma after oncológico, and then maybe "although the usual course would be to think about treatment based on hormone therapy."

Sorry - I don't know what to do with the rest of it.

 

[Traductorachilena]

Hola Eric!
Thanks a lot for your help and your suggestions!!!

buen estado functional - good functional status

Silly me, I thought about "good functional status" but it sounded a little too literal. I was wrong!

virgen a tratamiento oncológico - virgin to oncologic treatment; in other words, the patient has not received things like chemotherapy or radiation; some sources might refer to this as a "treatment-naïve" patient

I would have never figured this one out because I had never seen/heard/read that a patient could be "virgen a un tratamiento" meaning he had no received that specific treatment. I have never heard "treatment naïve" either. I learned something new! Thank you for that!

Sorry - I don't know what to do with the rest of it.

Neither do I!! It seems like words were thrown on the paper with no rhyme or reason.
So no clue on a connection between "disseminated metsatasis" and "or visceral crisis at the expense of lymph node metastasis? (=>which I chose to use for "ganglionar" because I think the oncologist meant "actividad ganglionar" but just put "ganglionar")

Thanks a million for all your help, Eric! Maybe another native English-speaking forero will read this post and will help me figure out the rest
Angelica

 

[ChemaSaltasebes]

Por si sirve de ayuda adicional a lo ya comentado por Eric;

El paciente (cuenta con) [presenta] actividad metastásica diseminada, o crisis visceral, a expensas ganglionar además de ósea. Es virgen a tratamiento oncológico, aunque lo habitual sería pensar (sería razonable plantearse en este caso [en tanto se sospecha un tumor prostático primario]) en [un] tratamiento en base a hormonoterapia.

Aunque crisi visceral (visceral crisis en inglés) se relaciona generalmente con afectación o compromiso de órganos vitales, hay un número importante de profesionales que lo identifican de forma genérica con diseminación o carga tumoral -como parece ser el caso, a juzgar por la elección de "o"; [actividad metastásica diseminada] (o [crisis visceral]) a expensas ganglionar además de ósea.

A expensas ganglionar además de ósea debe entenderse relacionado con diseminación. Por ejemplo, actividad metastásica diseminada con afectación ganglionar además de ósea (con afectación principalmente ósea pero también ganglionar); (...) with (mainly) bone and (also) nodal involvement (with not only bone but (also) nodal involvement).

 

[Traductorachilena]

Por si sirve de ayuda adicional a lo ya comentado por Eric;

Por supuesto que me sirve, Chema, muchas gracias!
De hecho, esperaba la ayuda de algún hispanohablante con experiencia en el tema que me pudiera ayudar a desenmarañar la madeja de ideas y ... voilà ... aquí estás!

Muy agradecida por tu explicación tan clara del trozo y por las comas que pusiste en los lugares precisos, ahora se me hace bastante más fácil entenderlo.
No sabía que a veces se identifica [de forma genérica] "crisis visceral" con "diseminación tumoral." La "o" que me tenía confundida ahora tiene sentido!

Entre tu colaboración y la de Eric, creo que tengo todas las piezas del rompecabezas que necesitaba ... así que ahora a armarlo en inglés!
Mil gracias otra vez!