Prostate cancer
Personalising care for patients with biochemical recurrence

Case 2: Carlos

Carlos, 68 years old, has a history of PCa.

Assessment summary:

  • Medical history: diagnosed with high-risk PCa 6 years ago
    • Preoperative PSA: 21 ng/ml
    • N0M0 on bone scan and CT scan
    • Underwent RP+PLND, pathology findings:
      • pT3aN0, ISUP grade group 4 (Gleason 4+4)
      • Positive surgical margins (4 mm) posterolateral
    • Postoperative PSA: undetectable
    • Received adjuvant RT to surgical prostate bed, no ADT
  • 14 months ago: PSA: 0.2 ng/ml, N0M0 on bone and CT scan
  • Today:
    • PSA: 1.3 ng/ml
    • PSA-DT: 5 months
    • N0M0 on bone scan and CT scan
    • PSMA-PET/CT: uptake in 1 pelvic LN
    • ECOG PS: 0, no comorbidities

Which of the following options would you choose for this patient?