Case 2023: Lorenzo (expert opinion by J. Van Moorselaar)

Lorenzo, 61 years old, used to work as cook in one of the most crowded and best tapas bar in town. Now, he prefers spending his days at the other side of the bar evaluating other cooks’ creations. He likes to give them star ratings in his private diary. He was recently diagnosed with PCa. 

Assessment history:

• Comorbidities:
  • Minimal LUTS on tamsulosin
  • Type 2 diabetes mellitus on metformin 
• PSA: 10.8 ng/ml
• DRE: cT2b
• MRI: PI-RADS 4 lesion lateral left, no capsular penetration, prostate volume 41 cc
• Prostate biopsy: ISUP grade 3 (Gleason score 4+3) (2/3 targeted and 2/12 systematic)
• Standard imaging: no signs of positive lymph nodes or metastasis