For patients with low risk prostate cancer and with very large prostates (>80cc) with significant urinary irritative/obstructive symptoms at baseline, should a short course of neoadjuvant hormone therapy be used prior to EBRT to reduce the severity of urinary toxicity?  

A not so straight-forward question, given the results of PIVOT that suggests the majority of low-risk prostate cancer pts don't benefit from radical treatment, and the REDEEM trial that explored the value of dutasteride in low-risk patients. One thing is clear, though, which is many pts have signifi...

It is important to point out that using LHRH for downsizing is off-label use.