.09 is still considered undetectable, Though it may not be for much longer. The big question is what is the doubling rate. The medical community considers < .1 To be undetectable, you are still there.

If you had IMRT, that usually means the prostate bed was radiated. I had a prostatectomy followed 3 1/2 years later by IMRT radiation because the cancer came back. My PSA hit .2. That radiation is considered the lifetime radiation for that area of the body. My cancer came back again, 2 1/2 years later, and I went on Lupron full time. I do have BRCA2 and that is one reason it keeps coming back.

If you truly had weeks of IMRT radiation after your prostate cancer surgery then you cannot do it again.. At this point, you can use SBRT to zap metastasis that show up. I had that done to one of them on my spine. Seems to have worked, And it works quite well for a lot of people I know.

Do get genetic testing to find out if it could be a factor. Does anybody else in your family have cancer? You can get it here for free, takes 2 to 3 weeks to get the results and a genetic counselor will call you. They will send you a kit that you return in the mail. You have to live in the United States for this.

Prostatecancerpromise.org

2 1/2 years after I started Lupron, my cancer came back again (became castrate resistant) and I was put on abiraterone. That drug gave me high blood pressure for which I have to take three pills twice a day even now, six years later. It gave me four Afib events. It made my hot flashes a lot worse. But it kept my PSA low for 2 1/2 years, though it was only undetectable one month. It is recommended as the first ARPI drug to go to. After 2 1/2 years, I switched to Nubeqa I have been undetectable for the last 24 months. Abiraterone Was not a lot of fun but gave me 2 1/2 years. I know people that were on it for five years and it worked well for them.