Stefano (74 years old)

Stefano is a 74-year-old retired emergency call responder. He often picks up his phone with “112, what is your emergency?” before realising this is no longer his job.

He was diagnosed 10 months ago with UCa of the bladder metastatic to the pelvic lymph nodes and lungs and was treated with gemcitabine + cisplatin. The first scan showed a reduced metastatic burden; however, at the end of chemotherapy, the CT scan revealed new and enlarging lung lesions.

The patient started pembrolizumab, but 6 months later he shows again progressive disease.

Assessment summary:

• Medical history: severe diabetes mellitus (glycated haemoglobin [HbA1c]: 9.5%), hypertension
• ECOG PS: 1; increasing breathlessness and cough
• CT scan of chest, abdomen and pelvis: new and enlarged lesions in the lungs
• FGFR2/3 mutation status in diagnostic biopsy specimen: wild type

The patient is followed up by an endocrinologist for the management of his diabetes and is now well-controlled.