@jeffmarc You're right. My husband had prostate surgery as his first treatment. When the chief urologist presented the option of salvage surgery to remove lymph nodes, I found it was odd. I feel that even with the best surgeons, they still can miss the microscopic cells that may not show up on the scan. We've had this experience from his first surgery, which all tests and scans showed no spread. However, they found 0.1 mm of cancer in one of the seminal vesicles during surgery, and it was confirmed in pathology report. That's why I'm very uneasy when surgery was offered again yesterday. I know very tiny trace of cancer can be missed even on PSMA scan. I don't get the idea of putting my husband through misery twice if the salvage surgery fails, and then he would need radiation.