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

Manuel, 59 years old, is an enthusiastic tour guide at the Jardín Botánico-Historico La Concepción de Málaga. He is able to name and differentiate each and every tropical plant in the botanical garden. He was recently diagnosed with metastatic PCa.

Assessment summary:

• Medical history: former smoker (stopped 5 years ago)
• ECOG PS: 0
• Asymptomatic
• PSA: 14 ng/ml
• Prostate biopsy: ISUP grade group 4 (Gleason score 4+4)
• Bone scan: 2 spots (T11 & right sacrum)
• CT scan: locally advanced prostatic mass, few enlarged pelvic lymph nodes >2 cm, no visceral metastasis
• Clinical stage: cT3N1M1