You need to see an oncologist for advanced cancer, and not just a urologist. Definitely make sure you go directly to the right type of doc so you don’t waste time. With his widespread tumors, I think they might recommend aggressive systemic treatment of chemo.
Pluvicto works best for tumors in bones, but not as well for soft tissue tumors. Possibly ADT immediately, then chemo asap, then down the road, Pluvicto for remaining tumors. My husband is at the end of 6 years of numerous types of treatments.