Ten years between PSA tests is a long time - as former Pres Biden just found out. But, what’s done is done……

These things are rarely straightforward; the more you get into this, it sometimes gets more complex. You’ll need to dig into it, learn more, self-advocate, and share in the decision-making to get the best outcomes.

Regarding exercise —> walking 3-4 miles/day is great (and well-documented) for overall health. But, the toxic side-effects of ADT require a bit more (as this clinical trial demonstrated): https://journals.lww.com/acsm-msse/fulltext/2023/04000/resistance_exercise_training_increases_muscle_mass.2.aspx)

However, walking 3-4 miles/day will help with the emotional/mental health side-effects of ADT (as these doctors recommended in this PCRI conference a few years ago): https://m.youtube.com/watch?v=8n0cIhamFvo

But, since you might not be able to exercise the way that these doctors recommended: https://m.youtube.com/watch?v=YE61HSAsFb0), you’ll have to come up with alternatives to offset the physical side-effects of ADT —> alternative exercises like like using your own bodyweight, or trying TRX, or taking a water exercise class (which is what I did at one point). There are many resistance-training alternatives to weightlifting.

Another question —> You’ve mentioned “PET/CT” and “PET results.” Is that a PSMA PET scan that you recently had?

All the things you mentioned will guide discussions with your medical team. If they use standard NCCN guidelines (see attached), there are general treatments they’ll recommend for you. But, you’ll have the final say in what happens.