For Prostate Cancer Awareness Month, Herbert Lepor, MD, discusses the leading concerns in managing early prostate cancer and tailoring strategies to the patient based on their risk and goals.
|Videos|December 2, 2020
A 66-Year-Old Man With Metastatic Castrate-Sensitive Prostate Cancer
Author(s)Ralph V. Boccia, MD
Recommendations for using AR-targeted therapy as an approach when managing patients with metastatic castrate-sensitive prostate cancer.
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Case: A 66-Year-Old Male with Metastatic Castrate-Sensitive Prostate Cancer
Initial presentation
- A 66-year-old man presented with mild intermitted back pain
- PMH: DM; medically controlled; OTC analgesics for pain
- FH: No known family history of cancer
- PE: DRE revealed an enlarged prostate; otherwise unremarkable
Clinical Workup
- PSA 70 ng/mL
- Core needle biopsy with TRUS showed adenocarcinoma of prostate
- Gleason score (4+4)
- Bone scan revealed 4 spinal lesions (T8/T9, L1/L2) and 1 in the right femur
- Chest/abdominal/pelvic CT scan was negative for distant metastases
- Diagnosis: stage IV mCSPC
- ECOG PS 1
Treatment and Follow-Up
- He was started on ADT + apalutimide 240 mg qDay
- At 2-month follow up: PSA 10 ng/mL
- No new lesions on repeat imaging
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