Ethan (57 years old)

Ethan, 57 years old, is a voice actor for animated characters and can't help but slip into character at family gatherings. His kids adore his goofy voices, but his wife sometimes wishes he'd use his normal voice to ask for the salt. Unfortunately, he was diagnosed with PCa.

Assessment summary:

Medical history & comorbidities:
- TURP for bothersome LUTS 2 years ago
- Type 2 diabetes mellitus on metformin
ECOG PS: 0
PSA: 9 ng/ml
Clinical stage (DRE): cT2b
mpMRI: PI-RADS 3 lesion lateral left, no extracapsular extension, large TURP defect
Prostate biopsy: ISUP grade group 4 (Gleason score 3+5)
CT (abdomen/pelvis) + bone scan, or PSMA-PET/CT: no signs of positive LNs or distant metastasis

Which of the following treatment options would you choose as a next step for this patient?

EBRT + short-term ADT (≤6 months)

EBRT + long-term ADT (≥1.5 years)

EBRT + brachytherapy boost

EBRT + brachytherapy boost + long-term ADT (≥1.5 years)

EBRT + long-term ADT (≥1.5 years) + 2 years abiraterone

RP + ePLND