After an RARP Your PSA should drop to undetectable. The problem is apparently your cancer has spread outside your prostate capsule. The IDC-P is a big problem. I’m surprised they didn’t change your Gleason score to at least a 4+3.

If you want to know how you can get care at other places, you should go to ancan.org and Attend one of their veterans groups. It meets twice a month. The guy running at knows everything about how to get Around the VA and get treatment from other places. They’ve been doing this for many years and are extremely experienced. The leaders are a colonel and a general (retired).

Now for more information about IDC-P.

There’s a study about it here
https://www.mdpi.com/2072-6694/16/9/1650#:~:text=Emerging%20evidence%20underscores%20the%20association,risk%20stratification%20and%20therapeutic%20interventions
From that study
Emerging evidence underscores the association of IDC-P with aggressive disease and poor clinical outcomes across various PCa stages. However, standardized management guidelines for IDC-P are lacking. Recent studies suggest considering adjuvant and neoadjuvant therapies in specific patient cohorts to improve outcomes and tailor treatment strategies based on the IDC-P status. However, the current level of evidence regarding this is low. Moving forward, a deeper understanding of the pathogenesis of IDC-P and its interaction with conventional PCa subtypes is crucial for refining risk stratification and therapeutic interventions.

Going to a center of excellence may be your best chance at how long progression free survival.