Prostate cancer
Personalising care for patients with biochemical recurrenceCase 1: Henrique
Henrique, 70 years old, has a history of PCa.
Assessment summary:
- Medical history: well-controlled hypertension, diagnosis of intermediate-risk PCa 5 years ago:
- PSA: 11 ng/ml
- DRE: cT2a
- mpMRI: PI-RADS 4 lesion lateral left, no extracapsular extension, prostate volume 40 ml
- Prostate biopsy: ISUP grade group 3 (Gleason 4+3)
- Bone scan and CT scan: N0M0
- Underwent RP + ePLND, pathology findings:
- pT2, ISUP grade group 3 (Gleason 4+3)
- Negative surgical margins
- Postoperative PSA: undetectable, last undetectable PSA 28 mo ago
- Diagnostic work-up today:
- PSA is slowly rising
- 24 months ago: 0.10 ng/ml
- 21 months ago: 0.12 ng/ml
- 18 months ago: 0.11 ng/ml
- 12 months ago: 0.15 ng/ml
- Today: 0.23 ng/ml
- PSA doubling time: 20 months
- ECOG PS: 0
- PSA is slowly rising