Nigel (68 years old)

Nigel, 68 years old, spends his afternoons making homemade jams from fruit he picks at a local farm.

He was initially followed up in the internal medicine clinic for ulcerative colitis. Now, he is referred for macroscopic haematuria. Investigations revealed MIBC with lung and diffuse nodal metastases.

Assessment summary:

• ECOG PS: 2
• Medical history:
  • Ulcerative colitis maintained on 5-aminosalicylic acid, recent flare (1 month ago) not requiring hospitalisation
  • Cachexia grade 1, asthenia grade 1 and weight loss grade 1
• Haemoglobin: 9.0 g/dl
• No peripheral neuropathy
• No hearing impairment
• GFR: 45 ml/min
• CT scan of chest, abdomen and pelvis: lung and diffuse nodal metastases in the para-aortic region
• PD-L1 expression: high