Brad (79 years old)

Brad, a very fit 79-year-old maintains his vitality with daily swims and hikes, a testament to the rewards of lifelong fitness. Unfortunately, he was recently diagnosed with PCa.

Assessment summary:

• Medical history: no relevant comorbidities or medication
• ECOG PS: 0
• Geriatric-8 (G8) score: 15/17
• PSA: 17 ng/ml
• Clinical stage (DRE): cT2b
• mpMRI: PI-RADS 4 lesion in right mid-peripheral zone, no extracapsular extension, prostate volume 40 ml, no bulky median lobe
• Prostate biopsy: ISUP grade group 5 (Gleason score 4+5)
• CT (abdomen/pelvis) + bone scan, or PSMA-PET/CT: no signs of positive LNs or distant metastasis