The purpose of this research study is to find out if giving radiation therapy (RT) early to high-risk bone metastases that are not causing pain can reduce the chance of skeletal-related events (SREs) such as fractures, spinal cord compression, or surgery to bone. This will be compared to the current standard of care (SOC), which usually treats bone metastases only when symptoms like pain occur. The study will enroll 16 participants locally over 25 months, and each subject will remain in the study for at least 40 months. You are being asked to join because you have metastatic cancer that has spread to your bones and is considered "high-risk," though it is not causing pain at this time. High-risk bone metastases are typically located in the spine, hip, shoulder, or long bones, and larger tumors in these areas are more likely to cause complications. If you join this study, you will receive radiation therapy to high-risk bone sites in addition to standard care. The main risk is that radiation therapy may not work better than the usual approach at preventing bone complications. Radiation can also cause side effects, including skin changes, tiredness, and inflammation of the esophagus, bowel, or lungs. There may also be risks that are not yet known to the study doctors.

The purpose of this study is to determine if we lower the chance of your prostate cancer growing or spreading by adding the drug relugolix to the usual radiation therapy? This study seeks to find if this approach is better or worse than standard of care for prostate cancer.

Treatment and follow up for this study may be up to 5 years. The procedures include blood samples, PET scans, hormone therapy and radiation therapy. Risks include diarrhea, back pain, weight gain, and headache. You may or may not receive a direct benefit from participating in this trial, however, information learned from the trial may help other people in the future.