Risk Stratified De-escalated Hormone Therapy With Radiation Therapy for the Treatment of Prostate Cancer

This study is testing whether a personalized, risk-based approach to hormone therapy duration combined with radiation can be used safely for men with high-risk prostate cancer, with the goal of reducing hormone therapy side effects for lower-risk patients while maintaining effectiveness. **You may be eligible if...** - You have a confirmed diagnosis of high-risk prostate cancer - Your cancer has one or more high-risk features: Gleason score 8–10, T3–T4 staging, or PSA ≥ 20 - Your cancer is staged as T1c–T4 with no or limited lymph node spread - You have an ECOG performance status of 0–2 (able to carry out most daily activities) **You may NOT be eligible if...** - Your cancer has spread to distant organs (metastatic disease) - You have received prior radiation therapy to the pelvis - You have significant other medical conditions that make hormone therapy or radiation unsafe - You are unwilling to sign institutional review board consent Talk to your doctor to see if this trial is right for you.