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As treatment for prostate cancer matures with many options for local, regional and systemic care, patients are living longer. Coupled with aggressive therapy for oligometastatic disease and improvements in multiple treatment pathways including radiopharmacy, both disease-free and overall survival are improving for many patients. Success can also bring new challenges that require new thought processes for care. In this paper we present two patients who had undergone previous radiation therapy for adenocarcinoma of the prostate with curative intent who required consideration for re-irradiation each more than 15 years away from primary management.