Disease progression after definitive therapy for prostate cancer is a major source of morbidity and mortality. Adrenergic/sympathetic innervation of the prostate is essential for prostate cancer progression, and abrogation of these signals by blocking adrenergic innervation halts disease progression. Long-acting neuraxial block of the sympathetic nerves that innervate the pelvis with dehydrated alcohol (>98% Ethanol) is a safe and effective tool in the treatment of chronic pelvic pain and cancer- induced pelvic pain. Furthermore, ultrasound guided periprostatic neuraxial block at the time of prostate biopsy with short-acting lidocaine is standard of care. Herein the research team proposes to administer a long-acting periprostatic neuraxial block with dehydrated alcohol and lidocaine under trans rectal ultrasound guidance in patients with high-risk clinical features for prostate cancer at the time of prostate biopsy.

Inclusion Criteria:

• PSA >10
• PSAD >0.15
• PI-RADS 5 lesion on MRI
• Karnofsky performance status >80
• Ability to understand and the willingness to sign a written informed consent.

Exclusion Criteria:

• Prior or concomitant treatment for prostate cancer, including radiation therapy, focal therapy, cryo therapy, androgen deprivation therapy.
• Imaging or clinical evidence of metastatic disease.
• PSA > 100ng/mL

Limited to Male with high risk prostate cancer clinical features

Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices).

Beginning 9 months and ending 36 months following article publication.

Researchers who provide a methodologically sound proposal.

To achieve aims in the approved proposal.

Proposals should be directed to ali.zahalka@mountsinai.org. To gain access, data requestors need to sign a data access agreement. Proposals may be submitted up to 36 months following article publication. Data will be shared by email.