What length of ADT do you recommend in a patient with a very low risk prostate cancer who otherwise has a PSA >20?

I would start by confirming that I feel comfortable with their biopsy results:

1) ensuring that there appears to be adequate sampling of the prostate on biopsy,

2) obtaining an MRI to make sure there is not a concerning appearing lesion that was not sampled (for instance, anterior disease),

3) would al...

My home institution published on this scenario considering the non-specific nature of an elevated PSA.

In summary, these patients appear to act similar to high risk disease and should likely be treated as such (long course ADT+radiation).

Gestaut et al. Clinical Genitourinary Cancer 2017