I had RRP prostate removal in late 2016 at Johns Hopkins. By March 2017, PSA had risen to about 15. No indication of a CAT scan of where/how the cancer spread. Rather than salvage radiation, the oncologist recommended that I get a PSMA CT scan. I believe it was experimental at that time. The scan showed "innumerable, very small tumors throughout my lymph system". So I avoided salvage radiation, which would not have been helpful. I started on Eligard (same active ingredient as Lupron). That worked to lower my PSA for more than a year. The JH protocol involved an Eligard injection to lower PSA levels, then holding off until the quarterly PSA levels started to increase. Eventually, the Eligard alone lost its effectiveness. Moved to abiraterone/prednisone while continuing the Eligard. When PSA started to increased, tumors grew in size, and spread to bone as well as lymph, the oncologist put me into a research study call STEPUP (alternating enzalutamide and high dose testosterone depending on PSA response. Eligard continued. The study protocol lost its effectiveness this spring. I started Provicto in August and await the results of blood work next week, and the 2nd of 6 infusions in early October. Eligard continues. So, I've been on Eligard for over 8 years. My ED has been complete for that entire time. My blood pressure is low and is managed with medication and a substantial loss of weight. As with many aspects of prostate cancer, the experience, treatment, and course of the disease vary considerably by person. All the best to all of you on this journey.