Case 2023: Sebastián (expert opinion by J. Stranne)

Sebastián, 68 years old, spent his younger days climbing in the area of El Chorro. He won’t admit it, but he is getting older, so his climbing activities are now limited to the Alcazaba. He will tell you that he reaches the top in one hour, but it actually takes him much longer. During the climb he enjoys the panoramic views of his beloved city Malaga.

His neighbour was diagnosed with metastatic PCa and his concerned wife sent him to the GP. Sebastián's PSA was 5.5 ng/ml.

He was referred to a urologist. The initial work-up resulted in the following:

• DRE: prostate volume slightly enlarged, a few hard nodules
• Prostate volume: 35 ml
• PSA: 5.7 ng/ml
• MRI: PI-RADS 4
• PSA density: 0.16 ng/ml

Sebastián is otherwise healthy and has no major comorbidities.