Prostate cancer

Topic: Diagnosing clinically significant PCa

Case 1: Piet (68 years old)

Piet is a 68-years-old retired railway employee. During a yearly check-up at the GP, his PSA was 4.2 ng/mL. He was referred to a urologist. The initial work-up resulted in the following:
  • DRE: prostate volume (PV) slightly enlarged, no suspicious findings
  • PSA: 4.5 ng/mL
  • PV: 40 mL
Piet is otherwise healthy and has no major comorbidities.

Which of the following options do you consider most appropriate for this patient?