Yeah, John, I think we all fear that to some degree. You have a few spots of concern in addition to the ‘normal’ need for salvage therapy.
The only way you’ll know is after you’re off ADT (firmagon?) and your PSA remains low. If it does not, then another PSMA, and possibly spot SBRT to mop up.
You have a long way to go before any of this even becomes an issue - and hopefully it does not. So try to relax, know that what you are doing is pointing you in a positive direction and in no way will be considered useless or futile in hindsight.
This miserable disease is like a huge tree hanging over your house; you have to take it down in pieces, little by little, until you get the job done. You got this…Best,
Phil