How do you manage androgen deprivation in a patient with oligometastatic prostate cancer in which the primary and all known metastatic sites have been treated with curative intent radiation and PSA remains undetectable?   

A great question and one that we don't have data for yet! In the absence of data, we can fall back on what we know about prostate cancer and its response to radiation and hormonal therapy, and remember the goals of treatment. Studies in the localized setting combine ADT with RT for 3-26 mo, with l...

Other factors enter into my decision. Age. health, length of time to metastases, psa doubling time. I do not rely on gleason score alone. In addition, lower gleason scores can be wrong, We only have gleason score from biopsy. We know that patients often have higher scores when they undergo prostatec...