About 15% of patients with localised prostate cancer (PCa) are identified as having a high risk for disease recurrence and these patients account for the vast majority of PCa deaths. To date, however, the optimal treatment for patients with high-risk, localized PCa remains controversial. While it is important to offer these patients an effective treatment, this treatment should not come with excessive side effects or impact the patient’s quality of life (QoL).1 During a session at the 2022 BMUC meeting, the different treatment options for these patients were discussed from the perspective of the surgeon, the medical oncologist and the radiation oncologist.