Gavin (72 years old)

Gavin, 72 years old, was a former standing cellist and captivated audiences with his performances. Nowadays, he listens to classical music for several hours each day and teaches his grandchildren aural skills. He hopes they will appreciate classical music as much as he does. He was diagnosed with high-risk PCa 5 years ago and treated with RP + ePLND (pT3aN0M0, negative surgical margins, postoperative PSA 0.02 ng/ml).

1 year later, the PSA rose to 0.20 ng/ml. He was treated with salvage EBRT which resulted in an undetectable PSA.

Again 1 year later, the PSA increased to 1.56 ng/ml (N0M0 on bone scan and CT). He received ADT and PSA dropped to 0.08 ng/ml.

The following 3 years, his PSA was monitored. Today, the PSA is 5.3 ng/ml, with a PSA-DT of 6 months (serum testosterone 18 ng/dl).

• Bone scan: negative
• PSMA-PET: 3 positive bone lesions (all vertebral) without a morphologic correlate on CT scan

He is fit (G8 score of 15), has an ECOG PS of 0 and has no relevant comorbidities.