The Prostate Cancer Genius app includes the following components: (1) educational content that is consistent with existing evidence and recommendations for prostate cancer and prostate cancer screening but has been adapted for the African American male population and for adults who read at or below the 8th-grade level; (2) real-time messages about the risks of prostate cancer and the benefits of completing a PSA test, placing a special emphasis on screening considerations for individuals with a family history of prostate cancer and/or lower urinary tract symptoms (measured via the American Urological Association Symptom Score); (3) general trivia that also incorporates quiz questions about prostate cancer and the PSA test; (4) African American-specific testimonials and educational videos; (5) optional counseling by African American prostate cancer survivors; and (6) on-demand, automated ordering of a home-based PSA test.

Participants assigned to use the Prostate Cancer Genius App will receive a combination of (a) scheduled and (b) on-demand content prostate cancer for one month. Scheduled content will be delivered on specific days each week using app notifications. Participants will also receive tailored navigation for ordering a home-based PSA kit, including receiving follow-up information from trained medical professionals about their test results.

Prostate Cancer Genius App

The Prevention Taskforce app provides on-demand access to evidence-based recommendations for prostate cancer for men between 55 and 69 (i.e., it can be accessed as needed).

Participants assigned to use the US Prevention Task Force app will download the app from Google Play and will be instructed to use the app for one-month to to become more informed about prostate cancer. They will also be instructed to download a companion app from the Google Play store. This companion app will be used to deliver weekly assessments and order a home-based PSA test kit if the participant chooses to so. Participants assigned to the Prevention Taskforce app will receive a brochure providing details about the purpose of the home-based PSA test.

US Prevention Taskforce App

Jan Foisy

Jordan Neil, PhD

Adam Alexander, PhD

Prostate tumor antigen-modified autologous DCs

1 to 2 injections, with an interval of one month, of 1\~2x10\^7 DC vaccine administered subcutaneously

Immunomodulatory DC vaccines to target prostate cancer

Lung-Ji Chang, PhD

Participants will be asked about your views and personal opinions on barriers of prostate cancer screening in the Black community, with a specific focus on Black men in church. Participants will also watch an educational video about prostate cancer and review specialized prostate cancer guidelines for Black men and will be asked to provide feedback about these materials.

The focus group will take about 2 hours to complete and will be led by the study Investigator and a research coordinator. A member of the research team will also take notes during the focus group, and the discussion will also be audio recorded and transcribed (written down word for word).

Additionally, participant demographic information will be collected (such as your age).

The focus group will take about 2 hours to complete and will be led by the study Investigator and a research coordinator. A member of the research team will also take notes during the focus group, and the discussion will also be audio recorded and transcribed (written down word for word).

Additionally, participant demographic information will be collected (such as your age).

Prostate Cancer Screening

This study seeks to investigate biochemical failure rates for patients treated with SBRT utilizing Elekta machines, as well as obtain quality of life data and assess the intrafraction motion in approximately 15 patients for 5 years following SBRT.

SBRT uses advanced imaging techniques to deliver targeted radiation to a tumor. The Elekta Versa and Agility Systems are approved by the Food and Drug Association (FDA) for SBRT treatment of cancer.

Stereotactic Body Radiation Therapy (SBRT) radiation for prostate cancer utilizing the Elekta Versa or Agility System.

This study seeks to investigate biochemical failure rates for patients treated with SBRT utilizing Agility Systems, as well as obtain quality of life data and assess the intrafraction motion in approximately 15 patients for 5 years following SBRT.

This study is open to patients with a pathologic diagnosis of localized prostate cancer and have expressed a desire to receive SBRT over other therapies

Participants in this arm will use the online "Talk to Nathan about Prostate Cancer Screening" decision aid before their clinic visit.

This decision aid is publicly available at this website in both English or Spanish: https://www.cdc.gov/prostate-cancer/talk-to-nathan/index.html

Use of the online "Talk to Nathan about Prostate Cancer" decision aid

Participants in this arm will use a standard decision aid before their clinic visit.

The standard decision aid is available here and will be used in either English or Spanish: https://massclearinghouse.ehs.state.ma.us/PROG-CANC/CA1382kit.html

Use of a standard prostate cancer screening decision aid

Participants in this arm will use standard education materials before their clinic visit.

The standard education materials are available from the National Cancer Institute (NCI) website in English or Spanish: https://www.cancer.gov/types/prostate/patient/prostate-screening-pdq

Use of standard prostate cancer education materials

Nancy Sacco, PhD

Bryan Crabtree, CCRP

All Veterans will receive SST (if De novo, Veterans will receive prostate-directed radiation).

Androgen deprivation therapy (ADT) using an LHRH agonist

Goserelin, Histrelin, Leuprolide & Triptorelin

ADT adding anti-androgen therapy to an LHRH agonist

ADT + Nilutamide, Flutamide, & Bicalutamide

Degarelix & Relugolix

ADT + Docetaxel +/- prednisone

Enhanced SST using Abiraterone + Prednisone

ADT + Abiraterone + Prednisone

Enhanced SST using Abiraterone + Methylprednisolone

ADT + Abiraterone + Methylprednisolone

ADT + Apalutamide

ADT + Enzalutamide

Veterans in ARM 1 will receive prostate-directed RT only and NO treatment to any nodal or distant metastatic sites.

Acceptable dose/fractionations include 55 Gy in 20 fractions and 36 Gy in 6 fractions.

Veterans in ARM 2 should receive prostate-directed local therapy using radiotherapy or radical prostatectomy in addition to PET-directed local therapy to metastases.

Prostate-directed Radiation for De novo oligometastatic prostate cancer

In addition to SST, all Veterans will receive PET-directed local therapy to all metastases using surgery or radiation. If De novo, Veterans will also receive prostate-directed radiation or radical prostatectomy to treat the prostate/prostate bed. The best course of treatment will be determined using shared decision-making between the physician and Veteran.

Surgery will be used to treat metastases.

PET-directed Local Therapy using Surgery

Radiation therapy will be used to treat metastases.

Radiation options include:

1. Stereotactic body radiotherapy (SBRT) using 1-10 fractions
2. Conventionally fractionated radiotherapy using elective nodal radiotherapy and a simultaneous integrated boost to involved nodes

The selection of the form of metastasis-directed radiotherapy for each metastasis will be determined using shared decision-making between the treating physician and the Veteran.

PET-directed Local Therapy using Radiation

For Veterans who have a local recurrence in addition to oligorecurrent metastatic lesions, they will undergo salvage local therapy using brachytherapy, SBRT, surgery, cryotherapy or HIFU. The selection of modality of salvage local therapy will be determined using shared decision-making between the treating physician and Veteran.

전립선암 천재 앱, 미국 예방 태스크포스 앱

전립선암을 표적으로 삼는 면역 조절 DC 백신

전립선암 검진

Elekta Versa 또는 Agility 시스템을 활용한 전립선암에 대한 입체조사방사선치료(SBRT) 방사선 치료.

온라인 "전립선암에 대해 Nathan과 상담하기" 의사결정 지원 도구 사용, 표준 전립선암검진 의사결정 지원 도구 사용, 표준 전립선암 교육 자료 사용

+ 프레드니손, ADT + 아비라테론 + 메틸프레드니솔론, ADT + 아팔루타미드, ADT + 엔잘루타미드, 신규 소전이성 전립선암에 대한 전립선 지향 방사선 치료