I was going to comment, then I read what https://connect.mayoclinic.org/member/00-ae6a0fe74b2768b5313442/
and https://connect.mayoclinic.org/member/00-153c33197d8a889a373320/ said, not sure I can add anything...

Anymore, for De Novo metastatic PCa, doublet and triplet is mainstream clinical practice.

If you were to add ADT for a defined period, using Orgovyx may be an option as it has a faster recovery of testosterone once stopping.

One consideration if you decide to treat, whatever combination and for however long is what clinical data will constitute "success," how you will actively monitor once off treatment.

I have two friends who had their surgery at around the same time I did, 11 years later they see their urologist once a years. I on the other hand...

I've peaked behind the door of death by versus with PCa, it's a hard no for me and my medical team knows it.

In the 11 years, only three have been on active treatment. The only difference in what I do on versus off treatment is I "feel" better off, otherwise, nothing changes, as an example, I completed the Bataan Memorial Dearth March near White Sand, NM and the Garmin Unbound, a 50_ mile gravel bike ride in the Flint Hills of Kansas while on 18 months of Lupron as part of triplet therapy. My wife and I did the Ring Road in Iceland for 12 days while I was on 12 months of Orgovyx,

I pretty much went to the gym most days while on treatment, you should be able to also.

Kevin