Wilhelmus (72 years old)

Wilhelmus, 72 years old, lives at the seaside together with his wife and his dog Charlie. Every day, they go for a short walk followed by drinking a cup of coffee in their favourite tearoom at the promenade. He was diagnosed with high-risk PCa 9 years ago (pT3aN0, ISUP grade 4, postoperative PSA <0.1 ng/ml). The disease progressed to mCRPC 5 years ago (bone). He received enzalutamide as first-line and 6 cycles docetaxel as second-line therapy.

Follow-up today (1 year after stopping docetaxel):

• No comorbidities
• No relevant family history
• ECOG PS: 1
• No pain
• Rising PSA: 110 ng/ml
• PSMA-PET/CT: progression in bone and LNs (max 3.5 cm in short axis) and liver (all lesions with PSMA expression)
• Somatic (tumour) testing: no mutation identified