Radiation-based approaches to the management of T3 prostate cancer

Locally advanced prostate cancer is rarely cured by conventional external beam radiation alone. Although occult micrometastatic disease is common, so is locally persistent tumor. This may provide the source of symptomatic local recurrence or metastases in the future. Efforts to improve local control through radiation dose escalation and through the use of neoadjuvant androgen suppression are showing promise. Adjuvant androgen suppression is also under study for those at highest risk of disseminated disease.