@ddl wrote "I agree, but have a question. I you’ve been on ADT and your T has been at castration level that long, isn’t any remaining cancer by definition castrate resistant?"

Unfortunately, no. It might just be dormant, at least according to my oncology team, and exposure to testosterone might make it active again (ADT doesn't so much kill prostate cancer as hit the "Pause" button). Once the cancer starts growing again, it has more opportunity for mutation, including mutations that create castrate-resistant cells.

That said, future research could throw more light on this. Once they have a way to detect dormant cancer cells in our blood or elsewhere, they'll have a better idea of what's going on. And maybe they will even find situations where BAT makes sense for nmCSPC and mCSPC.