Patient Note — 260163

4/13/26, 2:15 AM Print Preview [PATIENT_NAME] DOB: [DOB] (79 yo M) Acc No. [ACCOUNT_ID] DOS: 04/10/2026 Progress Notes Patient: [PATIENT_NAME] Provider: [PATIENT_NAME], MD Account: [ACCOUNT_ID] DOB: [DOB] Age: 79 Y Sex: Male Date: 04/10/2026 Phone: [PHONE] Address: [ADDRESS], WOODBRIDGE, VA-[ZIP] Pcp: [PATIENT_NAME] Subjective: Chief Complaints: 1. 4 WK F/U PET REVIEW. HPI: Elevated PSA/Screening: 80yM with Gleason 4+3=7 prostate cancer. Presents today for 4 week follow up PET scan review --------------- The patient's previous work-up history is listed below: 4K PSA (December 2025): 6.36 ng/mL 4K Score (December 2025): 72.2 % pMRI (December 2025): 1. There are no findings identified to correspond with a focus of significant abnormality (Gleason 7 or higher). 2. BPH -20g. Rec: PSA Surveillance. PI-RADS 2. ROS: 11 system Review of Systems completed in the chart and all pertinent positives and negatives reviewed with the patient , adg. Medical History: Hypertension, High cholesterol, Elevated PSA, Prostate Cancer. Surgical History: Appendectomy . Family History: Father: deceased. Mother: deceased. Screening: Social History: Recreational drug use: no. Exercise: yes. Caffeine: yes. Sexually active: no. Occupation: no. Tobacco Control (Standard) Tobacco use: Nonsmoker AUDIT-C (Standard) Did you have a drink containing alcohol in the past year? No Points 0 Interpretation Negative Medications: Taking Metoprolol Succinate , Taking Rosuvastatin Calcium , Unknown Albuterol Sulfate , Unknown Budesonide , Unknown Vitamin B-6 50 MG Tablet Oral , Unknown Isoniazid 300 MG Tablet Oral , Unknown rifAMPin 300 MG Capsule Oral , Unknown Ethambutol HCl 400 MG Tablet Oral , Unknown Pyrazinamide 500 MG Tablet Oral Allergies: N.K.D.A. Objective: Provider: [PATIENT_NAME], MD Date: 04/10/2026 1/2 4/13/26, 2:15 AM Print Preview [PATIENT_NAME] DOB: [DOB] (79 yo M) Acc No. [ACCOUNT_ID] DOS: 04/10/2026 Vitals: Assessment: Assessment: 1. Prostate cancer - C61 (Primary) 2. Elevated prostate specific antigen [PSA] - R97.20 Plan: Treatment: 1. Prostate cancer Notes: I personally reviewed PET scan and discussed the findings with the patient. PET(March 2026): Radiotracer-avid nodule in the lateral right prostate lobe, consistent with biopsy-proven prostate cancer. No evidence of seminal vesicle or neurovascular bundle involvement. No evidence of regional nodal or distant metastatic prostate carcinoma. Mild to moderate right pleural effusion, without radiotracer activity. Cytology evaluation may be warranted if clinically indicated. (Independently reviewed the actual images/tracings and came to my own conclusions) I detailed radiation therapy. The options include brachytherapy, external beam, and cyberknife in which the timeline varies depending on the method. I also detailed the side effects of radiation which include urinary frequency, urgency, and nocturia. I additionally discussed the use of hormone therapy in conjunction with radiation therapy. I explained that hormone therapy