Feasibility of Hormones and Radiation for Intermediate or High Risk Prostate Cancer

Inclusion Criteria: * Age \> or = 70 years and/or Charlson comorbidity index score \> or = 2 * Pathologically (histologically) proven diagnosis of prostatic adenocarcinoma * Two or more of the following intermediate risk features for recurrence, Gleason Score = 7, PSA 10-20 ng/ml, Clinical Stage T2b-T2c Percent positive biopsy cores \> or = 50% * One or more of the following high risk features for recurrence, Gleason Score 8-10, PSA \> 20 ng/ml, Clinical Stage T3a-T4 * Clinically negative lymph nodes as established by imaging, nodal sampling, or dissection * No evidence of bone metastases on bone scan * History/physical examination via the Charlson Comorbidity Index within 60 days prior to registration * Zubrod Performance Status 0-2 * Age \> or = 18 * Baseline serum PSA within 60 days prior to registration * Baseline serum testosterone obtained within 60 days prior to registration * Study entry PSA and serum testosterone must not be obtained during the following time frames, 10-day period following prostate biopsy, following initiation of oral androgen manipulation, within 30 days after discontinuation of finasteride or dutasteride * CBC/ differential obtained within 60 days prior to registration with adequate bone marrow function * Patient must be able to provide study-specific informed consent prior to study entry * Liver function parameters as follows, Total Bilirubin \< or = 2 x institutional upper limit of normal, AST (SGOT) or ALT (SGPT) \< or = 2 x institutional upper limit normal Exclusion Criteria: * Prior radical surgery (prostatectomy), high-intensity focused ultrasound (HIFU) or cryosurgery for prostate cancer * Prior hormonal therapy, such as LHRH agonists (e.g., goserelin, leuprolide), antiandrogens (e.g., flutamide, bicalutamide), estrogens (e.g., DES), or bilateral orchiectomy * Use of 5-alpha reductase inhibitors (finasteride, dutasteride) specifically prescribed for the treatment of prostate cancer * Prior or concurrent cytotoxic chemotherapy for prostate cancer; prior chemotherapy for a different cancer is permitted * Prior radiation, including brachytherapy, to the region of the prostate that would result in overlap of RT fields * Active lupus or scleroderma * Severe, active co-morbidity, including but not limited to,unstable angina within the last 6 months without subsequent corrective cardiovascular procedure,or acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration * Hepatic insufficiency with AST, ALT, or Bilirubin \> 2 x upper limit of normal,clinical jaundice, and/or coagulation defects * Acquired Immune Deficiency Syndrome (AIDS); note, however, that HIV testing is not required for entry into this protocol.Patients who are HIV seropositive but do not meet criteria for diagnosis of AIDS are eligible for study participation