Presentation

An 82-year-old male with a history of elevated PSA presented with a significant rise in levels.

He had previously undergone negative biopsies with no cancer detected. Fusion biopsies revealed Gleason 4+4 disease in 10% of the cores from a prostate with a volume of 144 cc. While surgery was considered, his age and prostate size increased the risk of postoperative incontinence. A PSMA-PET scan indicated multi-focal FDG activity.

Due to his ulcerative colitis, his initial radiation oncology consult advised that radiation treatment was relatively contraindicated.

PHM Actions

The PHM care team attended the client’s medical consults and took detailed notes, enabling him to debrief with the team and make more informed decisions.

They facilitated the ordering of a genetic panel that detected a germline mutation, prompting follow-up from the client’s family, particularly his son, due to their family history.

PHM also arranged consultations with specialists from a leading medical institution, including access to one of the few advanced imaging machines available on the East Coast.

Additionally, the team provided patient education to the client and his son on multiple occasions.