Case 1: Oliver (68 years old)

Oliver is a 68-year-old former barber. He still enjoys cutting his family’s hair, especially his nephew’s, who always requests very unique and creative haircuts.

He was diagnosed with PCa during a check-up.

Assessment summary:

Medical history: no relevant comorbidities or medication
PSA: 23 ng/ml
Clinical stage: T3a
Prostate biopsy: ISUP grade group 5 [Gleason score: 4 + 5]
Bone scan and CT abdomen/pelvis: no signs of positive lymph nodes or metastases
PSMA-PET/CT: no positive lymph nodes or metastases

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

External beam radiation therapy (EBRT) alone

EBRT + brachytherapy boost

EBRT + 1.5-3 years ADT

EBRT + 1-3 years ADT + brachytherapy boost

EBRT + 2 years ADT + 2 years abiraterone

Radical prostatectomy + extended PLND + sRT if needed