Authored by Tyler Seibert, published on 2026-04-30 05:28:27.0
Based on NCCN risk groups, Tyler Seibert, MD, PhD, Genitourinary Section Chief, UC San Diego Radiation Oncology outlines his general recommendations for patients with unfavorable intermediate risk prostate cancer (UIC PCa).
NCCN unfavorable intermediate risk
GG1
AS (See FIR)
GG2 cribriform (including IDC)
RT + stADT
Decipher
If cost not prohibitive, patient confident they can be reliable with PO medication, and especially if patient has high risk of cardiac issues
Relugolix x6 months
Most patients
Leuprolide x6 months
If borderline case for stADT or older patient
Leuprolide x4 months
RP
Close attention to post-RP surveillance. Consider stADT if secondary (post-op) RT needed
GG3
RT + stADT
Decipher
If cost not prohibitive, patient confident they can be reliable with PO medication, and especially if patient has high risk of cardiac issues
Relugolix x6 months
Most patients
Leuprolide x6 months
If borderline case for stADT or older patient
Leuprolide x4 months
RP
Close attention to post-RP surveillance. Consider stADT if secondary (post-op) RT needed