Prostate cancer
Biochemical recurrence after radical prostatectomy

Charlie (69 years old)

Charlie, 69 years old, is a retired librarian. He had surgery for intermediate-risk PCa 8 years ago (biopsy ISUP grade group 1 [Gleason score 3+3]; PSA: 12.4 ng/ml). Pathological findings: pT2a, pathological ISUP grade group 2 [Gleason score 3+4], negative surgical margins. Postoperatively, his PSA was undetectable, but now it’s slowly increasing.

Recent diagnostic work-up

  • PSA: 0.22 ng/ml (1st measurable PSA 18 months ago: 0.08 ng/ml)
  • PSA doubling time: 10 months
  • No molecular imaging available

No relevant comorbidities or medication.

 

Which of the following options do you consider most appropriate for this patient?