I'm 60 now. Still no progression, and my PSA remains undetectable, so I've been lucky. I've also been on ADT and Apalutamide continually since 2021 to help keep any remaining cancer cells dormant.

I'm not a medical professional, and could be wrong, but since the cancer has already left your prostate I'm not sure that removing the prostate would do a lot of good. Radiation can fan out and kill cancer near the prostate as well as the cancer in it, and with your local spread, that seems sensible.

Best of luck, whatever you decide.