Mixed feelings?? John , let me welcome you to Prostate cancer 101!!🤣. The whole thing is one great big mess of mixed feelings, contradictions and conflicting data.
I spent my entire 42 yrs in dentistry running and shielding myself from radiation; yet, I joyously leapt onto the table 25 times to bathe my body in its toxic beams…WTF??
We’re all between a rock and a hard place and ADT is no different: it starves the cancer but take too much of it and you could wind up dead (fatal heart attack/stroke) from it’s effects.
You ought to be concerned about radiation near the aorta, but luckily advanced computer mapping and very sophisticated machines make it possible to “shape” the beam around the aorta.
You really should talk to your RO about specifics - or get a second opinion. But I don’t think you can continue on ADT forever in order to avoid radiation.
But if you are in your high 80’s and upward it is possible since life expectancy comes into play and staying on ADT might be the best solution in that case.
Phil

Mine was referred to as malignant neoplasm of intrathoracic lymph nodes. Had a bronchoscope airway exam with endobronchial ultrasound biopsy of nodes on both sides of airway. Had 5 sessions of SBRT . Had two psma within a couple of months prior to biopsy and one scan showed the left brighter than the right and the next scan showed the opposite. In the end only one was positive. The psma scan also showed contradiction in pelvic and vertebrae . Because of the these PSMA's being questionable biopsy's are necessary before treatment.