@ucla2025
In March 2022, my PSA began a continuous climb over the next 12 months...

.12
.22
.48
.7
.77

That met our first and second decision criteria, three or more PSA tests showing an increase and between .5-1.0.

We imaged, it showed a single lymph node.

I met with my radiologist and oncologist. My going in position was SBRT to the lone lymph node and six months ADT, Orgovyx, in part based on the SPORT trial.

Radiologist supported that. Oncologist advocated for SBRT but 24 months ADT + ARI, aka, EMBARK trial.

We settled on SBRT, 12 months Orgovyx, hold the ARI, add only if PSA did not drop to undetectable in first three months, revisit our decision at 12 months, decide to come off or continue in three months increments, deciding at that point, continue, come off.

At the 12 month consultation, we agreed to come off treatment. Well, my oncologist supported my request to come off treatment, I know he would have liked me to do the full 24 with the ARI.

\Who was right, me. the oncologist? We'll never know. Like I said, make the best decision, don't look back.

At 20 months since our decision, only thing I know is we made a good decision.

As a side note, this disease has terms and definitions. When you say "salvage radiation" it generally means SRT - Salvage Radiation Therapy, which is radiation after BCR to the prostate bed only vice WPLN - Whole Pelvic Lymph Node or MDT - Metastases Directed Therapy. Given your clinical data, any radiation likely is MDT but only if imaging shows where to target and generally if no more than 3-5 sites.

Kevin