Prostate cancer
Tailoring treatment for metastatic hormone-sensitive prostate cancer

Gunther (62 years old)

Gunther is 62 years old and owns a cocktail bar. His signature cocktail of the season is the espresso martini, and he claims you can drink it at any part of the day. Gunther was recently diagnosed with metastatic PCa.

  • Medical history: hypertension, hypercholesterolaemia, smoker
  • ECOG PS: 1
  • Symptoms: back pain, weight loss over the last few months, urinary symptoms
  • Bone scan: 2 bone metastases (on vertebral bodies)
  • CT: locally advanced prostatic mass, multiple enlarged pelvic lymph nodes >2 cm, no visceral metastases
  • PSA: 143 ng/ml
  • Prostate biopsy: ISUP grade 4 (Gleason 4+4)

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