Prostate cancer
Tailoring treatment for metastatic hormone-sensitive prostate cancer

Andrew (67 years old)

Andrew is 67 years old and his favourite hobby is to play boardgames with his wife. They both take it very seriously and always keep scores; the loser has to prepare the Sunday dinner.

  • Medical history: history of falls with brief loss of consciousness. Epileptic absence seizure has been suspected but not confirmed
  • 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?