@jeffmarc Yes, exactly. The phase III STAMPEDE trial showed a benefit from primary-directed treatment for oligometastatic prostate cancer, but not (so far) for high-volume metastatic.

@beaquilter for metastatic prostate cancer, when they do treat the primary site it's almost always via radiation. STAMPEDE didn't even consider surgery as an option. It's extremely unlikely they'd recommend removing your spouse's prostate under any circumstances.