Do you dose escalate a patient with high risk prostate cancer who refuses ADT due to potential side effects?

I would treat the elective pelvis to around 50 Gy with a simultaneous boost to the LN to as high as tolerable based on proximity to the bowel. The prostate should be taken to normal dose-escalated levels depending on your fractionation, and you can add a microboost to a DIL. I generally do not add a...

I would treat with standard options of definitive EBRT to prostate and gross node, as feasible based on location and OAR tolerance, along with elective dosing to pelvic nodal basins up to likely the aortic bifurcation.

I would not escalate further than normal EBRT doses. Consideration could be give...

First, I'd get a PSMA PET scan to check for bony mets, and assuming it was negative, would try again to convince the patient to take at least a short course of androgen ablation.

Assuming he continued to refuse androgen ablation, I'd take the prostate and involved nodes to 70 @ 2.5/d, with the clini...