ozzie51, It sounds like you have a good team working quickly for you! Unfortunately my husband was diagnosed in an emergency scenario with biopsy of a peritoneal lymph node of which almost killed him as he because septic and thankfully recovered. His current oncologist and former oncololgist refuse to even mention orchiectomy; he was immediately put on Casodex and within a month on Enzulamide (Xtandi) for 5 months (PSA .34, which is down from a high of 717 in June of 2023) and now to start a PARPi. It took 2 months after his biopsy to get a PSMA-Pet so by the time he got it what he had initially was not as bad due to the meds working but he has metastatic disease in his lymph nodes, rib, should, spine and thankfully not seen in his any organs. He did get the somatic and germline testing so the PARP is suppose to address the gene mutations that he has and starve the cancer cells but with lots of side effects (husband is 76 yrs old, has heart disease, prior strokes, stage 4 kidney disease, 14 year survivor of bladder cancer) . His Oncologist refuses to do Chemo and radiation or radium 233 (he has no pain in his bones or lymph nodes at this time, he did several months backs). I believe his Oncologist is taking the OLD SCHOOL SOC vs the new to be more aggressive upfront treatment. Oncologist did say he thought Chemo would be too difficult for him to handle. Do you mind letting us know where you are getting your treatment? We feel that time is being wasted and whenever we ask questions the Oncologist tells us we are welcome to go elsewhere! Even his Urologist from a very good medical institution has not even set a followup date for him and is pretty much not providing any guidance other than bladder and prostate concerns (he has the Urolifts and stroke related issues called neurogenic bladder along with enlarged prostate). Praying that what you have achieved with your PSA reduction continues and you have several options for your treatment with minimal side effects.