Ralph (67 years old)

Ralph is 67 years old and retired from his job as a carpenter. Over the years, he has built hundreds of treehouses. Ralph went to the doctor because of severe lower urinary tract symptoms and is now diagnosed with PCa.

Assessment summary:

• Bothersome LUTS (IPSS 18)
• Prostate volume: 100 ml
• T2bN0M0 based on DRE, MRI and bone scan
• Prostate biopsy: ISUP grade 4 (Gleason score 4+4)
• PSA: 23 ng/ml
• No comorbidities
• Currently not sexually active

He opts to undergo EBRT ± ADT.