Was the MRI of the prostate only?

Those results would indicate your PCa was metastatic, not localized. While surgery is not ruled out in that situation, akin to taking out the "mother ship," it would generally include some type of ADT, perhaps with an ARI, radiation, chemotherapy, depending on how aggressive you and your medical team choose to be.

While historically, we tended to think PCa spreads first to the surrounding tissues, then the PLNs, then bones and organs, working it's way outward and upward, I think we (the medical community upon which we ask for their experience, training and education and ourselves as patients) now understand it can leapfrog wherever the heck it "decides" to.

Others may chime in, I don't recall a member posing about a situation such as this though I don't doubt there is.

Like in business, you may want to look at this as a "sunk cost," the decision facing you know is to determine where your PCa is, when you know that, which the PSMA scan may provide, then you can decide on treatment - doublet, triplet, will you use radiation or just systemic therapy.

Let the forum know what your PSMA scan shows and members can give you their thoughts.

Kevin