@quaddick

It all might make sense if you did not have Decipher 0.81 . You have very aggressive cancer regardless of PSA level according to all papers I ever read. Maybe you can remind them about that fact ? Doctors are very busy and sometimes forget all of the findings that are listed in patient's profile. I caught them numerous times overlooking some details. Six mos of ADT is really very short time and can add a lot of benefit but of course you will decide what looks more manageable to you 👍.

Wishing you the best possible outcome and complete eradication of cancer 🍀🍀🍀 with whatever you decide !

@quaddick FWIW, my urologist also recommended NO ADT for salvage radiation; new studies showed that if recurrent PSA was < .7 you could avoid it. Mine was 0.18…
However, my RO at Sloan Kettering agreed with my gut feeling that I should have it - and I did with no regrets.
I realize your situation is different than mine since yours is primary treatment. But I just want to remind you that all these studies, scales of aggressiveness, and gradations of the Gleason Score (ie favorable low/unfavorable high, etc) are human interpretations of mathematical results; even AI at this point is based on human data.
My point is to err on the side of caution; ADT will absolutely make your PCa more responsive to radiation. While that is no guarantee of success, it does improve your chances.
I had 6 mos. ADT and while annoying, it was not a hardship. Many things in this life are much worse and last a lot longer! Best,
Phil