This study is being conducted to answer the following question: Can we lower the chance of your prostate cancer growing or spreading by adding either prostate removal surgery or radiation therapy to the usual combination of drugs? 
    
The purpose of this study is to compare the effects, good and/or bad, of adding either prostate removal surgery or radiation therapy to standard systemic therapy (SST). Standard systemic therapy includes androgen deprivation therapy (ADT) with or without the use of chemotherapy. The combination of SST and surgery or radiation therapy is considered experimental.