@denkea
This sort of shows why urologist should not be involved when the cancer comes back. The American Society of clinical oncology says that you should have salvage radiation at .2 and at .5 you should also have ADT if you waited.

That urologist apparently never kept up with standards of care. You really got lucky having a radiation oncologist you could work with directly.

One of the doctors in the ancan.org weekly advanced prostate cancer meetings, was treated by a urologist who ignored his rising PSA. By the time he realized that he was being neglected, he had a Gleason nine and metastasis spread. Fortunately, he was able to get it treated and is still doing OK in his mid 80s. Even a doctor can be misled by urologists that don’t keep up.