<s>[INST] I have had radiation and androgen hormone therapy for stage three (gleason 9) prostate ca.Recent bone scan negative, total testosterone level 18, but rapidly raising PSA (.01 to 9 withinsix month interval), recent CT shows large periaotic lymph nodes with negative pelvic findings.Treatments all started December 2011. I am a other wise healthy 81 year old retired physician.Any further recommendations for treatment?. [/INST] Treatment for Stage III prostate cancers meaning they cancer has spread beyond the prostate gland but have not reached the bladder, rectum, lymph nodes, or distant organs. Possible treatment options at this stage include:External beam radiation plus hormone therapyHormone therapy onlyRadical prostatectomy in selected cases. Watchful waiting for older men whose cancer is causing no symptoms or for those who have another more serious illness. Radical prostatectomy at this stage is not nerve-sparing and is often done with removal of the pelvic lymph nodes. Sometimes, it is also preceded by hormone therapy. Regards Chat Doctor.  </s>