The first question is how many metastasis do you have?. If five or less, they should be zapping them. If more than five, then they usually want to do chemo or Pluvicto.

There is no reason you should wait for this. If you have metastasis to the bone, they can get worse, Even on ADT.

If your PSA has become undetectable, it can stop the metastasis from growing and spreading, But you still want to get them zapped With SBRT radiation if it is possible. Some metastasis are in areas that can cause problems if they zap them.

You have to be proactive for your treatment. Many doctors will just let things go or not let you do certain things unless you really press them, that you want that done. If you can’t get your doctor, you have now to do something then you do need to go to another center of excellence, At least for a second opinion.