What radiation treatments would you offer an older man with unfavorable intermediate-risk prostate cancer, with comorbid conditions, if you don't feel he is a good candidate for full-course radiation therapy with ADT?  

I would consider full dose RT and omission of ADT for this patient; most commonly in our practice, this is 70 Gy in 28 fractions but any standard regimen is reasonable to me. I often reference this study by Nabid et al., PMID 33279855 when considering treatment options for unfavorable intermediate p...

What is the point of treatment at all if an elderly patient has significant comorbid conditions? I would first consider the likelihood that they would even live 5 to 10 years and fully discuss the side effects of all treatments. There is nothing wrong with watching these patients and not making deci...

In general, I do not usually consider age in determining the fractionation schedule to recommend. I feel that a 5-day course of SBRT delivered 2-3x weekly would be very similar to a 6-fraction course delivered weekly for the patient. I think it would have similar tolerability and convenience, a...

I agree with the sentiments of Dr. @Patel, Dr. @Fleming, and Dr. @Horne.  The Artera datasets show that many patients with unfavorable-intermediate risk disease don't derive much absolute risk reduction from short-term ADT, so I am very comfortable omitting it in patients who participate in sh...