Very High Risk Prostate Cancer

Authored by Tyler Seibert, published on 2026-03-30 21:28:01.0

Based on NCCN risk groups, Tyler Seibert, MD, PhD, Genitourinary Section Chief, UC San Diego Radiation Oncology outlines his general recommendations for patients with very high risk prostate cancer (PCa).

  1. NCCN very high risk
    • RT + ADT x24 months
      • Younger, good health, and either very high Decipher
        • Add abiraterone x24 months
          • Consider elective RT to pelvic nodes
      • Age >70 or poor health or low/int Decipher
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