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What is your preferred management for a patient aged

66 years presenting with an IPSS of 19, PSA of 13.6,

Gleason score 4+4 prostate cancer which is stage T3a

on MR staging? He has no significant co-morbidities

a) Radical prostatectomy

b) Active surveillance

c) External beam IMRT to 78Gy with ADT

d) LDR d b h th

see rac y erapy

e) External beam IMRT + HDR boost