In a large study of men following radical prostatectomy for pT3 prostate cancer published in Eur Urol (2012) Briganti et al investigated whether radiotherapy was best given early (adjuvant) or delayed (salvage) until PSA started to rise (but was still below 0.51). 500 men were observed and 390 treated immediately. At 2 and 5 years there was no difference in PSA relapse (PSA >0.2). They concluded that it was safe to withhold radiotherapy until relapse, rather than treating all patients based on the risk that they may recur. This approach avoided treating 55% of patients that they monitored, thus avoiding the risks of overtreatment, without compromising cancer cure.