Take our patient case study curated for you by our editorial panel member Prof. William K. Oh.
A 60-year-old man presents with urinary retention, fatigue, and poor appetite
- Patient is a widower who works full time
- Initial Prostate-Specific Antigen (PSA) 150 ng/mL
- Transrectal ultrasound scan (TRUS) biopsy revealed adenocarcinoma of the prostate gland, Gleason score 8
- Computed tomographic (CT) chest abdomen pelvis (CAP) and bone scan negative for metastases
- No family history of prostate cancer
Initial Treatment
- He undergoes robotic radical prostatectomy with PSA that declines to 0.2 ng/ml
After 1 year
- PSA 90 ng/mL
- CT CAP and bone scan now shows multiple metastatic bone lesions in the pelvis, spine, ribs as well as diffused liver lesions
Diagnosis of Recurrence
- Patient is symptomatic with fatigue and bone pain
- Germline and somatic genetic testing is negative
What could be the optimal treatment option for this individual?