Only because you are 22 years away from your RP and have a 67 month doubling time, with a negative PSMA, it is not clear to me why all the PCa cells are in the prostate bed and not more likely elsewhere. While I appreciate that standard BCR protocol includes radiation to the prostate bed, you are not the typical BCR patient and 12 years removed from the timeframe that salvage radiation is typically used for BCR.

Therefore, I would go with @jeffmarc’s recommendation of taking Orgovyx, unless two different doctors could convince me with data that the PCa cells are likely confined the prostate bed and that radiation therapy has the potential to be curable or a significant life extension over only Orgovyx.