How would you treat prostate cancer that recurs after radical prostatectomy with invasion into bladder, rectum and musculature?

In a case with extensive disease like this, I would first restage ideally with a molecular study like PSMA to ensure no evidence of metastatic disease.

In the absence of metastatic disease, I would recommend starting with ADT (+/- abiraterone or other novel anti-androgen) to downsize disease away fr...