Local Ablative Therapy For Hormone Sensitive Oligometastatic Prostate Cancer

Inclusion Criteria: * Histologic diagnosis/confirmation of prostate adenocarcinoma and no evidence of small cell cancer. * Stage IV at presentation or relapse after curative intent therapy, classification per AJCC 8th edition: M1 disease with ≤ 5 metastases * ≤ 3 metastases in any non-bone organ system * Zoladex must commence within 12 weeks prior to randomization or within 12 weeks after randomization. * Radiology (CT/MRI chest/abdomen/pelvis) within 42 days of randomization * Bone scan within 42 days of randomization * All tumours (Primary prostate and metastases) must be amenable to local ablative therapy (radiation and/or surgery). * Age ≥ 18 * ECOG performance 0-2 * Patient is able (i.e. sufficiently fluent) and willing to complete the quality of life and economics questionnaires in either English or French * Patient consent must be appropriately obtained in accordance with applicable local and regulatory requirements. Each patient must sign a consent form prior to enrollment in the trial to document their willingness to participate * Patients must be medically suitable for study treatments as assessed by the appropriate specialties: medical, radiation, and surgical * Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen * Patients must be accessible for treatment and follow-up. Investigators must assure themselves the patients rando…