Case 2023: Mario (expert opinion by A. Bossi)

Mario, 80 years old, was the proud owner of a Marisquería at the beach that served the best ‘espeto de sardines’ in town. He still visits the seafood restaurant and enjoys the sunsets together with his friends near the barbecue fire. He was diagnosed with PCa 7 years ago.

Assessment history:

• Hypertension (under control with amlodipine)
• Deep vein thrombosis (treated with apixaban)
• 7 years ago (at age 73 years):
  • RP+ePLND for high-risk PCa
  • pT3aN0M0, negative surgical margins
  • Postoperative PSA 0.03 ng/ml
• 4 years later:
  • PSA rise to 0.18 ng/ml
  • Salvage RT, undetectable PSA
• 1 year later:
  • PSA rise to 1.30 ng/ml, N0M0 on bone scan and CT
  • ADT, PSA 0.09 ng/ml
• 2 years later (today):
  • PSA rise to 4.8 ng/ml, PSA-DT 7 mo
  • ECOG PS: 1
  • G8 score of 15 (fit)
  • Serum T 18 ng/dl
  • N0M0 on bone scan and CT