Thank you for the information and thoughts, now reporting back with an update from my health team.

Radiation --- With the location of the lymph notes in my upper chest/neck area and so close to my heart and lungs, radiation is off the table. Overall, with BRCA2, there is less chance that radiation will ever be a end-all solution.

Scan --- We reviewed my scan and the team wasn't aware of any recent usage of the comparison of SUV uptake to the reading in the blood and liver. That approach might still have validity and be part of a management plan, but the team at my hospital that does 25 scans a day, they don't use this approach.

Start/Stop --- We reviewed the question of whether starting ADT and then stopping it and repeating this cycle can lead to a quick transition from castrate sensitive to castrate resistant and they were not aware of this. We are looking for some clinical trials or related data to support this.

Next steps --- We took a much closer look at the results of the EMBARK trial and explored options of monotherapy with just Enzalutamide, monotherapy with just Relugolix, and dual theory with Enzalutamide and Relugolix. This was a good trial with plenty of people in each arm. We took a look at the ARAMON trial for Darolutamide and while good results, with just 23 patients it would benefit from more data. For what it is worth, my doctor is a little (not much, but some) concerned about Darolutamide drug for the seizure risk. We came to the overall conclusion that some form of treatment is inevitable but not urgent, so I'm going to do more research to make an informed decision about mono versus dual therapy and also see if the team has any new findings from the February conference. However this works out, I'll be on treatment in March.

Onward!