Paul (74 years old)

Paul is a 74-year-old retired carpenter. After many years living in the city, he recently moved to the countryside to enjoy the quiet and the nature.

Consider this patient’s medical history:

Treatment:

• 5 years ago: radical prostatectomy for T2 N0 M0 PCa
• 2 years ago: early prostate bed salvage RT without ADT for biochemical recurrence (PSA: 0.22 ng/ml)

Follow-up information today:

• PSA: 0.7 ng/ml, confirmed and increasing
• Asymptomatic
• Otherwise fit, no relevant comorbidities
• Bone scan and CT abdomen/pelvis: no signs of positive lymph nodes or metastases
• PSMA-PET/CT: uptake in right acetabular and L1 spinous process