Hi...I don't have treatment option advice, but I can relay my experience. I did not have surgery as my PCa was significantly metastatic at discovery, including bone lesions, but my current treatment plan (after IMRT to prostate) is ADT/ARSI, followed by targeted radiation to specific lesions as necessary.

You don't list ADT/ARSI as part of your treatment plan. If you are not on it, that's probably next. Best wishes.

ETA - Ha...North types faster than I do. 😊