5. Conclusions

The concurrent management of localized prostate cancer (with radiation therapy) and perianal fistula presents a complex clinical challenge, particularly given concerns regarding fistula progression, impaired wound healing, and infectious complications. In this case report, favorable intermediate‐risk prostate cancer was treated with definitive radiation therapy, followed by surgical management for a coexisting perianal fistula. Careful treatment planning, including efforts to minimize radiation exposure to the perianal region, allowed definitive prostate radiotherapy to be delivered while maintaining fistula control.

Our report highlights the importance of multidisciplinary coordination and individualized treatment sequencing in patients with concurrent prostate cancer and perianal fistula. Although broad conclusions regarding safety or wider application or generalizability cannot be drawn from a single case, this experience offers a practical example of how modern radiotherapy planning and staged surgical management may be integrated in a complex clinical setting. Further case reports with longer follow‐up are needed to better define patient selection criteria, technical considerations, and long‐term outcomes.