Melvin (72 years old)

Melvin is a 72-year-old retired accountant who finds refuge in his attic workshop, where he meticulously restores antique watches, each tick and tock a testament to his lifelong precision and dedication. He is diagnosed with PCa during a check-up.

Assessment summary:

• Medical history: chronic heart failure and atrial fibrillations requiring chronic anticoagulation
• Life expectancy 3-5 years
• ECOG PS: 3
• PSA: 23 ng/ml
• Clinical stage (DRE): cT3a
• mpMRI: PI-RADS 5 lesion lateral right, extracapsular extension, prostate volume 42 ml, no bulky median lobe
• Prostate biopsy: ISUP grade group 5 (Gleason score 4+5)
• CT (abdomen/pelvis) + bone scan, or PSMA-PET/CT: no signs of positive LNs or distant metastasis