The patient has difficulty in passing urine for the last 2-3 months. He was investigated and found with PSA-64.95 and USG abdomen done showed severe prostate enlargement (41x47x44mm, weight-48gms) with a focal bulge of the posterior superior surface of the prostate and MRI prostate done showed enlarged prostate (4.5×4.3×4.9cm) with heterogeneous signal intensity in the right side of the peripheral zone on prostate, which shows an exophytic loculated component of posterior aspect, involves a central zone of the prostate from the posterior aspect and bilateral seminal vesicles( right>left) with approx.1.0×0.6cm sized ill-defined altered signal in the peripheral zone of the prostate on the left lateral aspect with multiple well defined homogeneous signal intensity lymph nodes along bilateral iliac vessels followed TRU guided biopsy done and HPE showed acinar adenocarcinoma and bone scan done showed no evidence of skeletal metastases so advised for ADT and received 3#Leuprolide followed MRI Prostate done which showed around 70% improvement in size.  so advised to continue ADT and start radiation therapy (PSA-0.444 ). He has completed ADT and radiation therapy. After 3 months of treatment, we did a PSAM PET scan and it showed a complete response. So we can manage the disease without surgery and maintaining the quality of life. Click here to change this text