kenporter,
I think the decision will be reversed on appeal. Pylarify is the newest contrast agent and the most expensive. Insurance companies like to deny everything.
You may well die of something else because cancer treatments have improved greatly and you 'd better plan on more than ten. In another year you'll be outliving women 3 to 1.
I also think that it is great that you have 0 nodes. They will need to treat the seminal vesicle and since you've invited me to think, I think you should look at radiation with a Viewray Meridian.
https://www.nyp.org/locations/david-h-koch-center/mri-guided-radiation-therapy