Case 2023: Javier (expert opinion by A. Bahl)

Javier, 67 years old, has two beautiful grandsons who always visit him during the Procesión de Los Reyes. Together they enjoy watching the majestic parade, but mostly they enjoy the collection of sweets and eating the candy. The latter, of course, makes Javier their favourite grandpa. He was recently diagnosed with metastatic PCa.

Assessment summary:

• Medical history: type II diabetes (well-controlled with oral antidiabetic agent)
• ECOG PS: 1
• Symptoms: back pain and weight loss over the last few months
• Bone scan: 8 metastases (4 on ribs, 4 on spine)
• CT scan: locally advanced prostatic mass, few enlarged pelvic lymph nodes
• PSA: 63 ng/ml
• Prostate biopsy: ISUP grade group 5 (Gleason score 4+5)