Case 3: Marcos

Marcos, 66 years old, has a history of PCa.

Assessment summary:

• Medical history: diagnosed with high-risk PCa 6 years ago
  • Preoperative PSA: 21 ng/ml
  • N0M0 on bone scan and CT scan
  • Underwent RP+PLND, pathology findings:
    • pT3aN0, ISUP grade group 4 (Gleason 4+4)
    • Positive surgical margins (4 mm) posterolateral
  • Postoperative PSA: undetectable
  • Received adjuvant RT to surgical prostate bed, no ADT
• 14 months ago: PSA: 0.2 ng/ml, N0M0 on bone and CT scan
• Today:
  • PSA: 1.3 ng/ml
  • PSA-DT: 5 months
  • N0M0 on bone scan and CT scan
  • PSMA-PET/CT: uptake in 1 pelvic LN
  • ECOG PS: 1, has obesity, diabetes, and had a myocardial infarction 1 year ago, for which he receives metformin, aspirin, clopidogrel, atorvastatin ramipril and bisoprolol