Eugene (73 years old)

Eugene, 73 years old, used to do folk dance together with other local elderly people. Unfortunately, his disease symptoms no longer allow him to join the upcoming yearly performance. He was diagnosed with PCa 7 years ago.

Medical history:

• 7 years ago: RP for PCa (pT3bN0, ISUP grade 5, postoperative PSA <0.1 ng/ml)
• 6 years ago: salvage RT for rising PSA (0.53 ng/ml)
• 5 years ago: ADT started because of rising PSA (7 ng/ml), no metastases on conventional imaging
• 2 years ago: progression to mCRPC (bone), treatment with abiraterone started

Current situation:

• Ongoing treatment with ADT + abiraterone
• Rising PSA: from 0.9 ng/ml to 3.9 ng/ml
• ECOG PS: 1
• Back pain
• MRI spine:
  • Progression of existing bone lesions and new bone lesions in multiple vertebrae
  • Enlarging soft tissue component at Th9 causing spinal cord compression
  • Neurosurgical decompression was performed
  • Histology from neurosurgical decompression: metastatic poorly-differentiated PCa
• Somatic BRCA2 mutation