Men with Newly diagnosed oligometastatic disease
Oligometastatic disease (OM) is defined as 5 or less metastases seen on imaging. Patients are increasingly being diagnosed with oligometastatic disease due to the advent of sensitive imaging technologies. Classically, men with prostate cancer diagnosed with metastatic disease, even OM disease, are considered incurable and are treated with medicines and therapies to control the cancer for as long as possible. We have taken an aggressive approach to control OM cancer by treating with chemotherapy and hormone therapy to reduce the amount of cancer, then removing the primary cancer, treating the prostate bed and lymph nodes with radiation and also treating the sites of metastatic disease with stereotactic body radiation therapy (SBRT). Two Phase II trial are ongoing: TED1 enrolls men with newly diagnosed OM disease prior to surgery and TED2 enrolls men found to have OM disease (for example, positive lymph nodes) at the time of surgery.