Prostate cancer (US version)
Tailoring treatment for metastatic hormone-sensitive prostate cancer

Cody (51 years old)

Cody, 51 years old, is a bus driver. He enjoys driving around and meeting a lot of people every day, but he really cannot stand the traffic at rush hour.

He was recently diagnosed with metastatic PCa.

Assessment summary:

  • Medical history: none
  • ECOG PS: 0
  • Asymptomatic
  • Bone scan: 1 suspicious spot (Th11)
  • CT: locally advanced prostatic mass, few enlarged lymph nodes within the pelvis, no sign of visceral metastasis
  • PSMA-PET scan: 2 spots on the bone and 1 positive lymph node outside the pelvic area
  • PSA: 19 ng/ml
  • Prostate biopsy: ISUP grade group 4 (Gleason 4 + 4)

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