Clinical Summary (HPI)
Elevated PSA/Screening: 75yM with elevated PSA presents today s/p TP prostate bx (2/2/2026) for follow up. He is doing well s/p TP prostate bx (2/2/2026), without ER visits or hospitalizations. Denies bothersom storage or obstructive sx. No GH or dysuria. No testicular or prostate pain. ?hx of kidney stone. Postive family history of PCa in father, treated with Seeds. - - - - - - - - The patient's previous work-up history is listed below: PSMA PET/CT (02/2026): 0.8 cm radiotracer-avid nodule mid R prostate lobe, mSUV 8. No SV or NV bundle involvement. No regional nodal or distal metastatic PCa. s/p TP prostate bx (2/2/2026): Path: G 4+4=8 R PZ W #1 (40%) Prostatic adenocarcinoma. pMRI (11/2025): 31cc, PIRADS 2 PSA: 4.01, 4K 43.1 (11/2025), 4.7, %F 11.7 (10/2025), 3.2 (2024-verbal), 1.9 (2023-verbal) (Reviewed and interpreted) UA (11/2025): Neg, UCx: NG Labs (10/2025): Cr 1.03, CBC/CMP/LP wnl. (Reviewed and interpreted).
Raw Note (de-identified preview)
4/14/26, 7:53 AM Print Preview
[PATIENT_NAME] DOB: [DOB] (75 yo M) Acc No. [ACCOUNT_ID] DOS: 04/10/2026
[PATIENT_NAME]
75 Y old Male, DOB: [DOB]
Account: [ACCOUNT_ID]: [PHONE] SUMNER LAKE BLVD, MANASSAS, VA-[ZIP]
Home: [PHONE]
Guarantor: [GUARANTOR_NAME] Insurance: Medicare VA
(Palmetto)
PCP: ADVANCED UROLOGY Referring: ADVANCED UROLOGY
Appointment Facility: TELE-POTOMAC UROLOGY CENTER-MAN
04/10/2026 TV-F/U : [PROVIDER_NAME], MD
Reason for Appointment
1. Follow up
History of Present Illness
Elevated PSA/Screening:
75yM with elevated PSA presents today s/p TP prostate bx (2/2/2026) for follow up.
He is doing well s/p TP prostate bx (2/2/2026), without ER visits or hospitalizations.
Denies bothersom storage or obstructive sx. No GH or dysuria. No testicular or prostate pain.
?hx of kidney stone.
Postive family history of PCa in father, treated with Seeds.
- - - - - - - -
The patient's previous work-up history is listed below:
PSMA PET/CT (02/2026): 0.8 cm radiotracer-avid nodule mid R prostate lobe, mSUV 8. No SV or NV bundle involvement.
No regional nodal or distal metastatic PCa.
s/p TP prostate bx (2/2/2026): Path: G 4+4=8 R PZ W #1 (40%) Prostatic adenocarcinoma.
pMRI (11/2025): 31cc, PIRADS 2
PSA: 4.01, 4K 43.1 (11/2025), 4.7, %F 11.7 (10/2025), 3.2 (2024-verbal), 1.9 (2023-verbal) (Reviewed and interpreted)
UA (11/2025): Neg, UCx: NG
Labs (10/2025): Cr 1.03, CBC/CMP/LP wnl. (Reviewed and interpreted).
Current Medications
Taking
Lipitor , Notes to Pharmacist: 20 mg
Orgovyx(Relugolix) 120 MG Tablet 1 tablet Orally Once a day
Abiraterone Acetate 250 MG Tablet 4 tablets Orally Once a day
Screening
Vital Signs
Assessments
1.Prostate cancer - C61
Treatment
1.Prostate cancer
Progress Note: [PROVIDER_NAME], MD 04/10/2026
Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com)
Generated for Printing/Faxing/eTransmitting on: 04/14/2026 10:53 AM EDT
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4/14/26, 7:53 AM Print Preview
[PATIENT_NAME] DOB: [DOB] (75 yo M) Acc No. [ACCOUNT_ID] DOS: 04/10/2026
Notes:
Of note, he has: High-risk (PSA > 20, Gleason 8 or T3a)
PSA: 4.01, 4K 43.1 (11/2025)
pMRI (11/2025): 31cc, PIRADS 2
s/p TP prostate bx (2/2/2026): Path: G 4+4=8 R PZ W #1 (40%) Prostatic adenocarcinoma.
Decipher score: inadequate tissue.
PSMA PET/CT (02/2026): 0.8 cm radiotracer-avid nodule mid R prostate lobe, mSUV 8. No SV or NV bundle
involvement. No regional nodal or distal metastatic PCa.
Brachy Consult (02/26/2026, Dr. Ioffe): High-risk category prostate cancer (T1cN0M0). Despite high risk, he had only 1
core positive and low PSA; the MSKCC confirms low risk for LNI or SVI. Therefore, it is reasonable to offer prostate-only
directed therapy. We reviewed radiation options including EBRT and brachytherapy. He is a good candidate for
brachytherapy as monotherapy.
RadOnc (03/27/2026, Dr. Choe): High-risk PCa. Discussed Surgery vs 28 fractions of RT + ADT.
I discussed guideline-directed treatment, which would be EBRT + 18m ADT vs EBRT+Brachy with 1 year
of ADT. He was offered