A randomized trial comparing watchful waiting to radiation therapy without androgen deprivation for medium to high-risk Gleason 3+3 prostate cancer would be valuable.

“there would be a very interesting and elegant study taking let's call it medium to high risk 3 plus 3es so people based on family history or some other phenomenon genetic or otherwise right you randomize them to watchful waiting versus radiate them without androgen deprivation and you're really looking I mean you'd have to do this as a very long-term study so the question is outcome number one could be conversion to 3 plus 7 requiring surgery or andor androgen deprivation therapy and then of course outcome two the very long-term outcome would be overall survival”