I know a number of people that have had this issue. The usual recommendation is that you have Salvage radiation, which can give you more time before it comes back again. After that you would go on Lupron or an equivalent drug (Orgovyx, Eligard, Fermagon) When your PSA hits 2 After radiation.

Have you had a PSMA pet scan? A doctor would almost definitely advise that because your cancer has come back after surgery and you want to make sure it hasn’t metastasized. You must have that test before going on ADT because it will reduce your PSA and make the test less reliable.

3 1/2 years after surgery, my PSA started to rise and I had salvage radiation. That gave me 2 1/2 Years before it came back again, and I went on Lupron. I had a Gleason seven so my cancer was not as aggressive

The thing is you have cribriform. That makes your cancer, very aggressive, Along with the Gleeson nine it gives you a high percentage chance of having metastasis so you want to treat it aggressively. You should ask your doctor if your cribriform Is over .25 mm. If so, that makes it even more aggressive.

It sounds like your doctor is not following the standard of care. You should already have had salvage radiation based on NCCN and guidelines.. I think it would make sense for you to go to a center of excellence to be treated from now on. A Mayo Clinic, Or equivalent would be treating you differently than your doctor is treating you now. You have a very aggressive cancer you need to be proactive and get somewhere you can get the proper treatment.