How would you manage a patient with prostate cancer who has a history of total colectomy with primary anastomosis and is not a surgical candidate?

We favor brachytherapy alone in these patients. One patient we treated recently with history of IBD and J pouch after total colectomy, we tried space OAR which was difficult because of surgical scarring and the space craeted was not as optimal as patients without previous prior surgeries. However, w...