The side effects of androgen deprivation therapy (ADT) as general treatment against prostate cancer are known to impair quality of life. However, the optimal onset of ADT at PSA relapse is unknown, especially in patients with normal testosterone. In our case a limited PSMA avid lymph node was detected on PET/CT. Our case highlights the importance of metastasis-directed therapy balancing general versus tailored treatment in the decision making in the era of advanced molecular imaging. By using PSMA-PET/CT and radiation we were able to pinpoint the metastasis prolonging the ADT-free survival, thus sparing the patient the side-effects of continuous ADT.

Urology case reports. 2019 Aug 09*** epublish ***

Oscar Lilleby, Eivor Hernes, Wolfgang Lilleby

University of Copenhagen, Faculty of Medicine, Copenhagen, Denmark., Department of Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Department of Radiation Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway.