What you have is very treatable without a clinical trial. I had a prostatectomy and 3 1/2 years later my PSA started rising and I had 8+ weeks of radiation. PSA started rising again 2 1/2 years later went on Lupron. I’m now 16 years past the prostatectomy, I have BRCA2, which makes my cancer very aggressive, but I’m still around and in good shape at 78.. I’ve been undetectable for the last 24 months taking Orgovyx (ADT) and Nubeqa. I’ve had four reoccurrences but the drugs keep me under control.

Getting on ADT alone is not a good idea, You can become castrate Resistant within a couple of years with just ADT. That happened to me after 2 1/2 years, Once you become castrate resistant median survival is two years, I’ve been six years past that. If they give you an ARPI along with the ADT, it can delay, castrate resistance for a long time. Ask your doctor about this.

Some doctors like to just wait for the metastasis show up on a PSMA Scan and zap them with SBRT radiation. That can work.