@vircet Thanks Vir. My second biopsy was performed after an MRI showed two new lesions of concern. The area targeted was the right prostate with 10 samples of which 7 were positive for cancer and 5 of the seven had significantly high percentages of cancer (right anterior). PSMA scan I had 6 months later showed that the cancer was still concentrated in that right anterior section with none being noted on the left side. Still my PSA is above 10 and I have 3+4 grade so that alone probably puts me in the unfavourable category which does indicate ADT. I've decided not to use ADT for now although was advised to do so by the oncology team. I've gone the radiation alone route and have one more treatment left. I did think about it a lot and realise there maybe more risk this way in terms of cancer but am mostly comfortable with my decision.