Miguel (70 years old)

Miguel, a fit 70-year-old man, underwent RP for cT3aN0M0 prostate cancer [ISUP grade 3, Gleason score: 4+3] 3 years ago. During follow-up:

Asymptomatic
No relevant comorbidities
Rising PSA: from undetectable to 0.9 ng/ml
PSMA-PET/CT:
- Uptake in 3 extra-pelvic LNs (inguinal region, biopsy confirmed)
- Size ~2.1 cm

Observation

Local treatment M1a lesions

ADT monotherapy

ADT + local treatment M1a lesions (RT or surgery)

ADT + docetaxel

ADT + AR-targeted therapy

Enrol in clinical trial