Case 2023: Alejandro (expert opinion by E. Castro)

Alejandro, 67 years old, has always been intrigued by Picasso, because just like him, he was born in Malaga. That’s why he started to follow art painting classes since his retirement. After each class, he miraculously manages to end up with more paint on his clothes than on the canvas. He tries to convince his friends that it is a new modern look.

He was diagnosed with mHSPC 2 years ago (PSA 456 ng/ml, multiple bone metastases) and treatment with ADT + docetaxel was started (within clinical trial). After 6 cycles, his PSA dropped to 5 ng/ml.

Current situation:

• No comorbidities
• Family history:
  • Father died of PCa at age of 64 years
  • Brother diagnosed with high-risk PCa at age of 61 years
  • Germline testing: BRCA2 carrier
• ECOG PS: 0
• Asymptomatic
• Rising PSA: 98 ng/ml
• Testosterone: 17 ng/dl
• CT and bone scan: pelvic and retroperitoneal LNs, progression of bone metastases