Phil, I am so confused. I went and got a second opinion at a cancer center in Michigan, Karmanos. They believe my first rib is cancer also. I asked why they are saying that and they basing it on the brightness of the lesion which measured 6.3 on the SUV . Karmanos said to treat only the rib and not do SRT to the prostate bed and pelvic lymph nodes as nothing showed up there. They also said no ADT. Both of these things were suggested as to prevent side effects. Well, I started ADT a month ago because PSA jumped from.24 to .42 in 6 weeks. I have been marked up for SRT by first opinion Oncologist and am waiting for SRT to begin. After SRT complete I will start SBRT to rib. I had my prostatectomy in August of 2022 and was clear until this July. I had a Decipher score of .37 which was supposed to be low risk for metastatic disease. Everything I have read is that a solitary first rib lesion being cancer is rare, especially without spread to the spine or pelvis first. My SUV is moderate, squarely in the grey zone of being benign or cancer. The SUV ratio is 3.7 which is also in the middle between cancer or benign. I have clavicular joint arthritis as well as arthritis in knees and back which is supposed to increase chances of being benign but none of that seems to matter to the Oncologists, both Radiologist and Medical oncologists. Karmanos suggested getting rib treatment first. The plan I'm on is getting SBRT to rib after SRT. I have been inputting all my data into AI platforms and I'm receiving odds that rib is probably benign. Right now I'm lost and am losing confidence that anyone knows what is going on. I'm taking the most aggressive path for treatment at this time, side effects be damned. Can anyone on this board offer any advice or first hand experience in this?