Feasibility of Hormones and Radiation for Intermediate or High Risk Prostate Cancer

Inclusion Criteria:

- Age > or = 70 years and/or Charlson comorbidity index score > or = 2

- Pathologically (histologically) proven diagnosis of prostatic adenocarcinoma

- Two or more of the following intermediate risk features for recurrence, Gleason Score
= 7, PSA 10-20 ng/ml, Clinical Stage T2b-T2c Percent positive biopsy cores > or = 50%

- One or more of the following high risk features for recurrence, Gleason Score 8-10,
PSA > 20 ng/ml, Clinical Stage T3a-T4

- Clinically negative lymph nodes as established by imaging, nodal sampling, or
dissection

- No evidence of bone metastases on bone scan

- History/physical examination via the Charlson Comorbidity Index within 60 days prior
to registration

- Zubrod Performance Status 0-2

- Age > or = 18

- Baseline serum PSA within 60 days prior to registration

- Baseline serum testosterone obtained within 60 days prior to registration

- Study entry PSA and serum testosterone must not be obtained during the following time
frames, 10-day period following prostate biopsy, following initiation of oral androgen
manipulation, within 30 days after discontinuation of finasteride or dutasteride

- CBC/ differential obtained within 60 days prior to registration with adequate bone
marrow function

- Patient must be able to provide study-specific informed consent prior to study entry

- Liver function parameters as follows, Total Bilirubin < or = 2 x institutional upper
limit of normal, AST (SGOT) or ALT (SGPT) < or = 2 x institutional upper limit normal

Exclusion Criteria:

- Prior radical surgery (prostatectomy), high-intensity focused ultrasound (HIFU) or
cryosurgery for prostate cancer

- Prior hormonal therapy, such as LHRH agonists (e.g., goserelin, leuprolide),
antiandrogens (e.g., flutamide, bicalutamide), estrogens (e.g., DES), or bilateral
orchiectomy

- Use of 5-alpha reductase inhibitors (finasteride, dutasteride) specifically prescribed
for the treatment of prostate cancer

- Prior or concurrent cytotoxic chemotherapy for prostate cancer; prior chemotherapy for
a different cancer is permitted

- Prior radiation, including brachytherapy, to the region of the prostate that would
result in overlap of RT fields

- Active lupus or scleroderma

- Severe, active co-morbidity, including but not limited to,unstable angina within the
last 6 months without subsequent corrective cardiovascular procedure,or acute
bacterial or fungal infection requiring intravenous antibiotics at the time of
registration

- Hepatic insufficiency with AST, ALT, or Bilirubin > 2 x upper limit of normal,clinical
jaundice, and/or coagulation defects

- Acquired Immune Deficiency Syndrome (AIDS); note, however, that HIV testing is not
required for entry into this protocol.Patients who are HIV seropositive but do not
meet criteria for diagnosis of AIDS are eligible for study participation