@knoyes01 Radiation these days is a LOT more targeted than in the past. Salvage radiation uses computer assisted guidance to avoid (as much as possible) areas of healthy tissue such as bladder and rectum.
A simulation is done under ideal conditions - full bladder/empty rectum. The Xray computer program will scan you before each session to be sure that your internal organs are in the SAME position as the simulation in order to keep the beams focused only where the RO wants them.
Your only job is to follow the bladder/rectum protocol laid out by your team. You will be fine.
Phil

@knoyes01
Exactly you wait until your PSA hits one and the cancer is probably in your bloodstream and could come back anywhere. It does go dormant sometimes for years or decades, but more frequently. It comes back sooner..

You don’t mention your Gleason score that is a critical number That can tell you how aggressive the cancer is and how likely it is to reoccur.

@knoyes01 My second opinion GU at a CCC facility said to wait until 2.0 and they could find it and treat it. Same concerns as you. I can understand getting radiation and ADT at .2 one time in the bed area as it isn't unusual for cells to leak into the area and seems a reasonable hunch. What happens if we have a .2 recurrence after that? And another negative PET Scan? Do we end up on ADT for life or do we wait until 1.0 or 2.0 and then get another PSMA scan hopefully with evidence of where the cancer is? If I have to end up on ADT for life I would like it to be evidenced based. These decisions are emotionally tough. Best wishes on your journey and if you are up to it I would be interested in what you decided and the outcome. Chip