Lorenzo (61 years old)

Lorenzo, a 61-year-old commercial farmer of tomatoes, was recently diagnosed with PCa.

Assessment summary:

• Comorbidities:
  • Minimal LUTS (IPSS 7) on tamsulosin
  • Type 2 diabetes mellitus on metformin
• PSA: 10.8 ng/ml
• DRE: cT2b
• MRI: PI-RADS 4 lesion lateral left, no extracapsular extension, prostate volume 41 ml
• Prostate biopsy: ISUP grade 3 (Gleason score 4+3) (2/3 targeted and 2/12 systematic)
• Conventional imaging: no signs of positive lymph nodes or distant metastasis