The side effects of ADR, all types, are well known.

The questions is, if your husband accepts the recommendations of his medical team, which ones will he experience, what will their severity be...

It is not possible to answer that... We can give you our experience, but that's it.

I've been on ADT twice, 18 months of Lupron, 12 months of Orgovyx

Side effects I experienced:

Weight gain - mid-section
Hot flashes
Fatigue
Muscle and joint stiffness
Genitalia shrinkage

All were annoying, irritating, none were life altering in the sense of disrupting what I normally do - go the gym, ride my bike, do yard work, ski, vacation, o to concerts....

When I stopped ADT, the side effects gradually subsided, faster with Orgovyx than Lupron

Some men will experience depression, if they are able and willing to recognize it, their medical team can help.

If you are not familiar with the NCCN Guidelines, consider taking the time to do so.

One thing that may mitigate the side effects is exercise. Running marathons is not necessary, nor are doing Ironmans... walking, swimming, biking, pickleball,...resistance training are definite consider doing. If he is not a lifelong fitness mindset, start slow, increase gradually.

From the clinical data you describe, appears he has had surgery and possibly SRT, now PSA is on the rise. At .015, he may not need to decide on treatment, rather continue with PSA tests as you describe. If it continues to rise, you can calculate PSA doubling and velocity using the MSKCC Nomograms - https://www.mskcc.org/nomograms/prostate/psa_doubling_time - that along with GS, Grade Group and results from imaging can serve to guide discussions on treatment

He may also consider imaging at a point in the future. Current PSMA pet scans can locate at .2 or lower but statistical probability is better between .5-1.0.

He will have choices if and when he decides to treat, a plethora of choices. Mono-therapy with ADT may not be one of those. Generally, doublet or triplet therapy with ADT, ARI, MDT, Chemotherapy...As part of those choices he may discuss intermittent ADT, treat for a defined vice continuous period, stop if undetectable, monitor, go back on when...

Acting solely based on a rising PSA, particularly one that is .15 may not be a decision he needs to make now. He may have time to gather additional data, then informed by that, decided in concert with his medical team.

Keep the members of the forum informed, lots of experience though as @hbp said, we are not medical experts who are trained, educated and board certified. Still, the school of hard knocks is a great teacher...

Here's an interesting article which may be pertinent to his decision making - https://www.urotoday.com/conference-highlights/apccc-2024/151514-apccc-2024-in-which-patients-with-metachronous-low-volume-mhspc-do-you-recommend-total-therapy.html?utm_source=newsletter_13176&utm_medium=email&utm_campaign=prostate-cancer-daily

Kevin