A 76-Year-Old Man With Recurrent Castrate-Sensitive Prostate Cancer

Case: A 76-Year-Old Male With Recurrent Castrate-Sensitive Prostate Cancer

History

• A 76-year-old man diagnosed with localized prostate cancer, 4 years ago
• At that time, he underwent EBRT

Currently

• Patient was lost to follow-up; returns due to intermittent hip pain
• PMH: obese, BMI 32; prostate cancer; otherwise unremarkable
• FH: No known family history of cancer
• PE: left hip tender to palpation, slight limp and evidence of decreased weight bearing on left lower limb
  
  

Clinical workup

• PSA 10 ng/mL; doubling time 3 months
• Core needle biopsy with TRUS showed adenocarcinoma of prostate
  • Gleason score (4+4)
  • Bone scan revealed 2 bone metastases: 1 in the left femur 1 in the left pelvis
• Chest/abdominal/pelvic CT scan positive for 4 pelvic lymph node metastases
• Diagnosis: stage IV mCSPC
• ECOG PS 1
   

Treatment and Follow-Up

• He was started on ADT + apalutimide 240 mg qDay
• At 3-month follow up: PSA 2 ng/mL
• Repeat imaging showed no new lesions