MMM , just my thought process here . IF it looks like your PSA is rising and it could be the start of a reversal , hit it hard and early with Salvage Radiation. At 0.13- 0.2 , normally its the ideal early stage to go after that rising PSA and bad cells in Pelvic region. MRI showed nothing and PSMA- PET scan would most likely show nothing at this low level , but you can be proactive . If yoru going to get Salvage at some stage go " pedal to the metal" is my thinking . your values are very low at 0.13 or so , so you maybe could get away with 20 or 22 (like me ) and no ADT . Im not a doctor , more of a decent Airline Pilot , but my father and grandfather had prostate cancer and my father died of prostate cancer at the age of 67. I have always got my physicals of course for my license and I used to go to the urologist for a routine check for five years even prior to being discovered and diagnosed with prostate cancer. I was that hyper focussed on earlier detection , if im going to get it ! My father was an engineer, very smart man, but hated doctors and never visited a doctor for 10 years at a time. He had to get a physical for an overseas project and that's when it discovered his PSA was about 18 or 20 I think it was. During his last six years of life I was his caregiver, as my mother and sister were too emotional around my father. I drove him back-and-forth from the hospital as he hated the hospital. I was with him to his last breath in heartbeat. Of course it took a lot out of me and gives me post traumatic anxiety at times. It's amazing, even my military experience flying active missions is less heavy on me and then look me up from my father during his last six months. I lose a lot of sleep over that. That happened over 25 years ago as well. Anyway, I wish you the best and pray for you every day. God bless. James on Vanc. Island .