You say you were on systemic treatment, What do you mean by that? That could mean many things. Are you on an ARSI? If your testosterone continues to rise, then Zytiga should get it back down. Studies have shown when your testosterone reaches 50 chances of your PSA rising goes up as well. You could speak to your doctor about getting you on Zytiga Or a drug like Nubeqa Which works even if you have testosterone. If you are not on an ARSI your chance of becoming castrate resistant is much higher than if you do get on one. Studies have shown that this is really important for people to do. Again, something to talk to your doctor about.