Towards Optimal Treatment for High Risk Prostate Cancer

This trial tests different radiotherapy strategies for men with high-risk prostate cancer — comparing various combinations of pelvic radiation and targeted boosts to the prostate — to find the safest and most effective approach. **You may be eligible if...** - You are a man 18 or older diagnosed with high-risk prostate cancer within the last 6 months (defined by tumor stage T3+, Gleason grade 4 or higher, or PSA of 20 or above) - You have an indication for radiation to the pelvic lymph nodes, or lymph node involvement shown on imaging (up to 4 suspect nodes) - You have had a PSMA-PET scan and MRI of the prostate - Your prostate cancer has not spread to distant organs **You may NOT be eligible if...** - You have had prior pelvic radiation - You have had a TURP (prostate scraping surgery) in the last 3 months - You have had a prostatectomy or other primary prostate treatment - You have inflammatory bowel disease or PSA above 50 - You have metastatic disease - You have had another cancer in the past Talk to your doctor to see if this trial is right for you.