Your urologist is no longer the person to talk to, they do not specialize in cancer, you should only be talking to them for urological issues. Dropping ADT would be a major mistake. Your cancer came back and you should be on ADT and probably Zytiga, that is normally the first step once you have metastasis showing up.

You have an active cancer, Gleason says 3+4 but that may not be correct. It might’ve made sense to get a second opinion on your Gleason after the RP.

Not sure where you’re going but a Mayo Clinic sounds like it would be a better choice than your doctor saying check the next labs.

You want to have a Genito Urinary Oncologist handling your case. They specialize in prostate cancer, unlike a medical oncologist who will work with all different kinds of cancer and don’t keep up with the latest developments in prostate cancer.

Dropping ADT now could just lead to your cancer spreading more. Having it zapped with SBRT isn’t enough when your cancer comes back after so many years and is found in multiple places.

Your life is on the line now, be proactive and get the best care.