Locally advanced prostate cancer refers to cancer that has spread beyond the prostate gland but has not yet reached distant organs. It typically includes clinical stages T3 and T4:

-T3: Tumor extends through the prostate capsule (T3a) or invades the seminal vesicles (T3b)

-T4: Tumor invades nearby structures such as the bladder neck, rectum, or pelvic wall

This stage is considered high-risk and often requires multimodal treatment, such as external beam radiation therapy combined with long-term androgen deprivation therapy (ADT). In select patients, radical prostatectomy with extended lymph node dissection may be considered, though additional therapy is often needed. The goal is to achieve long-term control and prevent metastatic progression.