In a similar situation as your husband except when discovered, my cancer had already metastasized past the point of surgery being a viable option. Full Dx is in my profile for reference, but it suffices to say that the Orgovyx/Nubeqa doublet is my primary treatment. We did zap the prostate with IMRT but my RO specifically told me that this was an additional treatment and that the drugs would be the primary. One thing I don't see brought up often is somatic testing of the malignancy itself. My GUO doc was very adamant about the importance of the genetic makeup of the cancer for future targeted treatments when ADT/ARSI stumbles. Best wishes.