Sorry for your diagnosis. My spinal metastasis was at T3, so we're in similar situations.

If there are only a few spots (oligometastatic), then they can often be radiated individually; Pluvicto and/or chemotherapy are more commonly indicated for many spots (polymetastatic). Note that while PSMA PET is the most-sensitive scan available, it also has a reputation for throwing up false positives, so those extra little spots may or may not be significant

For metastatic prostate cancer like ours, the STAMPEDE study demonstrated the benefit of also radiating the prostate itself within a year of diagnosis, and the TITAN trial showed a *very* strong benefit to starting Apalutamide at the same time as ADT (instead of holding it in reserve until the cancer becomes castrate-resistant).

Both of these were new ideas in 2021 when I was diagnosed (the common practice then was just to treat stage-4 palliatively), but I was lucky to be at a major Canadian cancer centre where they were up on the latest research. I hope this knowledge is more widely disseminated now, but it's still worth getting to a major cancer center/centre of excellence to make sure you're getting the benefit of the latest research, because things are changing fast.