⚠ DIAGNOSTIC PHASE — TREATMENT PLAN NOT YET APPLICABLEDIAGNOSTIC PHASE — TREATMENT PLAN NOT YET APPLICABLE. Histology required before any therapy discussion (CHARTER §15.2 C7).
Patient
PZ-DIAG-PROSTATE-001 · suspicion lineage: prostate_carcinoma
Tissues: prostate · Hypotheses: DIS-PROSTATE
63M with elevated_psa 12.4 ng/mL detected on routine screening; rising_psa from 4.1 ng/mL three years prior (doubling time ~2.4 y). DRE reveals abnormal_dre with right-base prostate_nodule. No 5-alpha-reductase inhibitor use. No recent prostatitis or instrumentation. Pre-biopsy multiparametric prostate MRI shows PI-RADS 4 lesion in right peripheral zone (1.2 cm) with restricted diffusion. Mild luts_with_psa (IPSS 9). No urinary_obstruction requiring catheterisation. No hematospermia. PSA density 0.21.
Matched workup: WORKUP-SUSPECTED-PROSTATE · Очікуваний термін: ~ дnoв
Workup steps (6)
- 1other Serum PSA
- 2consult Digital rectal examination of the prostate
Tactile assessment of prostate symmetry, nodules, and induration as part of initial diagnostic workup; contributes to clinical T-stage.
- 3imaging Multiparametric prostate MRI (T2 + DWI + DCE) — PI-RADS v2.1
Pre-biopsy lesion localization and PI-RADS scoring to direct targeted (MRI/US-fusion) biopsy; reduces clinically insignificant cancer detection; assesses local extent (extracapsular, seminal vesicle invasion).
- 4lab Complete Blood Count with Differential
Baseline cytopenia assessment and ongoing monitoring of myelosuppression.
- 5lab Comprehensive Metabolic Panel
Електроліти (Na, K, Cl, HCO3), креатиnoн + BUN (renal function), глюкоза, кальцій, альбумін, total protein. Базова метаболічна оцінка перед будь-якою терапією + основа TLS risk + dosing adjustments.
- 6lab Renal function panel with eGFR (creatinine, BUN, electrolytes)
Baseline renal function before iodinated contrast, nephrotoxic systemic therapy, partial vs radical nephrectomy planning, and HRR / cisplatin eligibility.
MDT brief
MDT talk tree (3 steps)
| # | Owner | Topic | Action |
|---|
| 1 | pathologist | Specialist review | Any suspicion requires biopsy — pathologist plans site selection, IHC panel, ancillary tests. |
| 2 | radiologist | Specialist review | Stage / restaging imaging + biopsy guidance — radiologist. |
| 3 | surgical_oncologist | Specialist review | Suspected solid tumor — resectability assessment, biopsy approach. |
Skills (required) — mandatory virtual specialists (2)
- Pathologist (general) required
Any suspicion requires biopsy — pathologist plans site selection, IHC panel, ancillary tests.
- Radiologist required
Stage / restaging imaging + biopsy guidance — radiologist.
Skills (recommended) — for consideration (1)
Technical MDT skill metadata (3/16 activated in this plan)
All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).
| Specialist | skill_id | Version | Last reviewed | Sign-offs | Domain |
|---|
| Cellular therapy specialist (CAR-T) | cellular_therapy_specialist | v0.1.0 | 2026-04-25 | 0 | cellular_therapy |
| Clinical pharmacist | clinical_pharmacist | v0.1.0 | 2026-04-25 | 0 | clinical_pharmacy |
| Hematologist / oncohematologist | hematologist | v0.1.0 | 2026-04-25 | 0 | hematology_oncology |
| Hematopathologist (lymphoma / leukemia / myeloma) | hematopathologist | v0.1.0 | 2026-04-25 | 0 | hematopathology |
| Infectious disease / hepatology | infectious_disease_hepatology | v0.1.0 | 2026-04-25 | 0 | infectious_diseases |
| Medical oncologist (solid-tumor chemotherapist) | medical_oncologist | v0.1.0 | 2026-04-25 | 0 | solid_oncology |
| Molecular geneticist / molecular oncologist | molecular_geneticist | v0.1.0 | 2026-04-25 | 0 | molecular_oncology |
| Palliative care | palliative_care | v0.1.0 | 2026-04-25 | 0 | palliative_care |
| Pathologist (general) | pathologist | v0.1.0 | 2026-04-25 | 0 | pathology |
| Primary care / family physician | primary_care | v0.1.0 | 2026-04-25 | 0 | primary_care |
| Psycho-oncologist | psychologist | v0.1.0 | 2026-04-25 | 0 | psychosocial |
| Radiation oncologist | radiation_oncologist | v0.1.0 | 2026-04-25 | 0 | radiation_oncology |
| Radiologist | radiologist | v0.1.0 | 2026-04-25 | 0 | diagnostic_imaging |
| Social worker / case manager | social_worker_case_manager | v0.1.0 | 2026-04-25 | 0 | psychosocial |
| Surgical oncologist | surgical_oncologist | v0.1.0 | 2026-04-25 | 0 | surgical_oncology |
| Transplant specialist (BMT) | transplant_specialist | v0.1.0 | 2026-04-25 | 0 | cellular_therapy |