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PROSCA2019 - Case 01

Your case challenge (apply data presented at ASCO GU)


François is a 61-year old baker famous for his butter croissants and rainbow-colored macarons. Personally he prefers the English breakfast, with a lot of sausages. He recently realized he had to wake up twice more in the night for nocturia. He is a former smoker (15 pack/year) with no significant past history, except a pneumonia successfully treated with antibiotics 5 years ago. His mother was treated for breast cancer when she was about 50.

He is diagnosed with prostate cancer:

  • Clinical stage: cT3
  • PSA: 36 ng/ml
  • Gleason score: 4+4 [ISUP grade group 4]
  • Bone scan: 3 spots on the spine
  • CT: locally advanced prostatic mass, few enlarged pelvic lymph nodes, 1 spot on the lung, corresponding to a doubtful metastasis.
  • ECOG performance status: 1

Which treatment would you recommend for this patient?