Case 2025: Antonio (expert opinion by A. Bahl)

Antonio, 67 years old, owns a cosy café in Lisbon, where locals gather daily to savour a perfectly brewed bica. Antonio is not only appreciated for his rich espresso and the warm atmosphere; also his loyal friendship contributes to keeping the café culture alive.

Unfortunately, Antonio was recently diagnosed with mHSPC.

• Medical history: no abnormalities
• ECOG PS: 0
• PSA: 41 ng/ml
• Prostate biopsy: ISUP grade group 4 (Gleason score 4+4)
• Bone scan: 3 metastases (on vertebral bodies)
• CT: locally advanced prostatic mass; no lymph node or visceral metastatic disease

Antonio went to a different hospital to get a second opinion.

• PSMA-PET/CT: 9 metastases (6 on vertebral bodies, 1 in left ischium and 2 on the left rib), few positive pelvic LNs
• He will start treatment with ADT