This study investigates the effects of adding prostate removal surgery or radiation therapy to standard systemic therapy for treating prostate cancer. Prostate cancer is a disease where cells in the prostate gland grow uncontrollably. The purpose of this study is to see how these additional treatments affect patients with prostate cancer.

Participants will undergo either surgery to remove the prostate or radiation therapy, in addition to receiving standard systemic therapy. Standard systemic therapy is a treatment that uses medication to target cancer cells throughout the body. The study will compare the outcomes of these different treatment arms to understand their effects.

• Who can participate: Men with prostate cancer who have an intact prostate and have not received prior local therapy for prostate adenocarcinoma are eligible. Patients should not have known brain metastases, and if brain imaging is performed, it must show no disease.
• Study details: Participants will receive either prostate removal surgery or radiation therapy along with standard systemic therapy. This study does not involve a placebo.