So, what do you make of a urologist in this case. Two years after 43 rad sessions, my PSA begins to rise. It's gone from .9 to 2.16 in one year, a 140% acceleration. Previous PSMA shows part of prostate with likely cancer, but nothing spreading. Urologist says Eligard, immediately, no more active surveillance. I agree it's a rapid rise but do all the medical books say the same thing about what immediately triggers the need for ADT?