What radiation treatments would you offer an older man with unfavorable intermediate-risk prostate cancer, with comorbid conditions, if you don't feel he is a good candidate for full-course radiation therapy with ADT?

What is the point of treatment at all if an elderly patient has significant comorbid conditions? I would first consider the likelihood that they would even live 5 to 10 years and fully discuss the side effects of all treatments. There is nothing wrong with watching these patients and not making deci...

I would consider full dose RT and omission of ADT for this patient; most commonly in our practice, this is 70 Gy in 28 fractions but any standard regimen is reasonable to me. I often reference this study by Nabid et al., PMID 33279855 when considering treatment options for unfavorable intermediate p...

In general, I do not usually consider age in determining the fractionation schedule to recommend. I feel that a 5-day course of SBRT delivered 2-3x weekly would be very similar to a 6-fraction course delivered weekly for the patient. I think it would have similar tolerability and convenience, and be...

I agree with the sentiments of Dr. @Dr. First Last, Dr. @Dr. First Last, and Dr. @Dr. First Last.

The Artera datasets show that many patients with unfavorable-intermediate risk disease don't derive much absolute risk reduction from short-term ADT, so I am very comfortable omitting it in patients wh...