Hi Mike, I'm in a similar boat. Prostatectomy was 9 months ago, with positive surgical margins. Four months after surgery my PSA was 0.24, and nine months after surgery (now) it is 0.37. I'm told it is a high-risk local recurrence, and the PET scan was inclusive but might show small cancer in pelvic lymph nodes.

I'm starting ADT two days from now, and seven weeks of radiation therapy starting in late October. My ADT is going to include two years of ARPI, androgen receptor pathway inhibitor.

Radiation therapy comes several weeks after ADT has started, since that way the cancer cells will be weakened beforehand by the testosterone deprivation.