Normally, what you would do is radiation. The question is what does the PSMA PET scan show. Does it find any metastasis if so, they can be radiated with SBRT normally. If nothing can be found, they might want to radiate the prostate bed and the lymph nodes. This type of radiation usually works for a few years at least.

Another option is you just can wait until something pops up and then zap it. Some doctors believe in that strongly.

It’s the focal treatment concentrated on the prostate then it’s not there to do surgery on or have continued spread from that spot. It’s more likely that mini metastasis got away before the focal therapy was done, Could not be seen so they could not be treated.

My Mayo Doctor told me all options are on the table if it returns. Really depends on how and where it comes back.