This language version is in progress; translations will be added gradually.
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:
Active surveillance
RP ± PLND
EBRT alone
EBRT + short-term ADT
EBRT + brachytherapy ± short-term ADT
Focal therapy
Active surveillance
RP ± PLND
EBRT alone
EBRT + short-term ADT
EBRT + brachytherapy ± short-term ADT
Focal therapy
The first question concerns active treatment: yes or no? In this case it is a clear yes. Both radical prostatectomy and EBRT are good options. The next question is if any treatment should be added to EBRT. Adding short-term ADT to EBRT has the best result [1]. The addition of HDR brachytherapy did not show improved overall survival yet and might be overtreatment in this case [2]. Focal therapy is not yet ready for these unfavourable intermediate-risk cases [3]. Currently, almost half of the patients treated with focal therapy had an ISUP 1 tumour.