There is no doubt that the data support the earlier one does SRT, the greater the possibilities of a "cure." That cure depends on many things since generally, advanced PCa is not consider "curable," It may be if one is fortunate enough, managed as a chronic disease. Certainly the dizzying array of treatments and advances in imaging that have come into play during the last decade have changed how we treat and manage prostate cancer.

My thought was, he has choices, discuss those with his medical team, familiarize himself with the literature, NCCN guidelines, doublet, triplet therapy., then decide in conjunction with his medical team.

As an aside, my PSA was .3 when we started SRT in March 2014, 90 days after completing it, my radiologist hesitated before turning from her screen, then saying "Kevin, you're PSA has risen to .7, it didn't work,,,Granted, we didn't include the PLNs, nor did we add short term ADT, wasn't mainstream clinical practice then.

The questions with imagining in discussion with my medical team are usually:

Will the results change the treatment plan?
Is there a risk in waiting to image?

Those are questions pertinent to shared decision making between the patient and his medical team.

I'd be curious as to your definition of "success.?" How long are you after your treatment, months, years...a decade...?

The reason I ask is because many on this forum and others, define success as duration of progression free survival, time off treatment, not dying from it... For some that's 3-5 years, there are others, albeit limited, who 5-10 years later have had their prostate cancer rear it's ugly head. Then again, I have two close friends who had surgery from the same urologist who did mine, they are past the ten year point with no return of their prostate cancer. They were not high or very high risk (Grade Group 4-5), as I was and still am, rather intermediate.

Kevin