Normally, they would start salvage radiation at .2 PSA after a prostatectomy. If you wait, a lot longer then the cancer can get out of the prostate bed, which could make the salvage radiation insufficient. Can they zap the cancerous lymph node with SBRT radiation, and also give you salvage radiation. Or is that lymph node in the salvage radiation area?

Lupron is Apparently not working since your testosterone level is so high. It should be below 20 right now. This may mean you are castrate resistant, not castrate sensitive.

Normally, with what you describe, they would add a second drug, an ARSI like abiraterone, which can bring most peoples testosterone down very low, even if castrate resistant. Another alternative if abiraterone doesn’t work a lutamide actually makes the testosterone ineffective. There are Three main lutamines, apalutamide, Darolutamide and Enzalutamide. Darolutamide has the least side effects.

I’m telling you about this so that you are prepared when you speak to your doctor and know what the possible options are.