Radiotherapy or Surgery Combined With Intense Androgen Deprivation Therapy for mCRPC

This study is comparing two treatment strategies — surgery versus radiation — combined with intensive hormone therapy for men with low-volume metastatic prostate cancer detected on advanced imaging scans. **You may be eligible if...** - You have confirmed prostate cancer that has spread to 10 or fewer sites visible on a PSMA PET scan (an advanced nuclear medicine scan) - There is no spread to internal organs (visceral metastases) - Your testosterone level is not in the castration range (or has only been in that range for 3 months or less) - Your primary prostate tumor can be surgically removed - You are in good physical condition (ECOG 0–1) **You may NOT be eligible if...** - You have already received more than 3 months of hormone therapy or had surgery, radiation, or chemotherapy for prostate cancer - You have severe heart disease or uncontrolled diabetes - You have another cancer in the past 5 years (with some exceptions) Talk to your doctor to see if this trial is right for you.