Sorry I didn’t notice in your full explanation that you were on Orgovyx now.

While you can just continue Orgovyx and wait until you become castrate resistant (PSA rises, even though on Orgovyx) with the advance case you have you want to consider double therapy with Zytiga. You need to listen to the doctors and see what they have to say. You are at high risk and they want to try to give you the longest life possible with this disease. They might even recommend Triplett therapy with chemo, but you’ll probably get more than one opinion about that. With your PSMA PET scan being clear, they probably don’t want to do triplet therapy, you need to get that scan every few months, if you can, just to make sure you don’t have any metastasis showing up.

Not sure how long you have been on Orgovyx. Your PSA should drop to below one, even .1 but with EBRT it can take years to drop real low. In some case, it does drop low quickly, results are mixed. As long as you don’t have three rises in a row in your PSA things are usually working OK.