This study is for men with metastatic prostate cancer. This means the prostate cancer has spread to other parts of the body. The study is examining if adding surgery or radiation to the usual treatment helps patients live longer and stops the cancer from growing. Usual treatment, known as Standard Systemic Therapy (SST), involves medications or hormones that affect the whole body. Participants will be randomly chosen to receive either just SST or SST plus surgery or radiation.

• Time Commitment: Participants will be followed for 8 years after treatment.
• Treatment: Includes different types of hormone therapies and possibly surgery or radiation.
• Eligibility: Participants must have prostate cancer that has spread, but without brain involvement, and should not have had local prostate cancer treatment before.

The study also looks at how the treatments affect quality of life, like urinary function and pain. Participants will have multiple visits and tests throughout the study. There are no emojis in this summary to keep it professional and informative.