Prostate cancer
Tailoring treatment for metastatic hormone-sensitive prostate cancer

Walter (67 years old)

Walter is 67 years old and enjoys spending time with his grandchildren. During the last few months, he was feeling more tired than usual when playing with them in the garden. He was recently diagnosed with metastatic PCa.

  • Medical history: atrial fibrillation (ongoing treatment with rivaroxaban, an anticoagulant)
  • ECOG PS: 1
  • Symptoms: back pain and weight loss over the last few months
  • Bone scan: 8 metastases (4 on ribs, 4 on spine)
  • CT: locally advanced prostatic mass, few enlarged pelvic lymph nodes, 2 liver metastases
  • PSA: 63 ng/ml
  • Prostate biopsy: ISUP grade 5 (Gleason 4+5)
  • Liver biopsy: confirmed metastatic adenocarcinoma consistent with prostate primary

Which of the following treatment options would you choose for this patient?