Page 10 - Flipbook

Case Introduction

Patient history (2016):

• 59-year-old presents with weight loss (3-month
duration)

• PSA 26 ng/mL

• Biopsy shows Gleason 8 (4 + 4)

• CT/BS negative

• Received RT to the primary, PSA was then
undetectable

• Now, 66 years old, returns with rising PSA and back
pain

• PSA 22 ng/mL
• CT/BS reveals three spinal lesions, no

lymphadenopathy, no visceral metastases

How would you stratify this patient?

What treatments would you consider?

PSA, prostate-specific antigen; CT, computed tomography; BS, bone scan; RT, radiotherapy