You need to find an Oncologist to work with you. You are beyond the experience of a urologist to really help you properly. Going to a center of excellence and getting treated there could make a lot of sense.

Do you live in the USA? There’s a big difference between Canadian treatment and USA treatment.

Lupron and Eligard are essentially the same drug. They Both use leuprolide. While lupron was unavailable for about nine months, Five years ago it became available right after that and has not had a problem in production since.. No reason to change since they both work the same. Hopefully, you are getting at least a three month shot. I got six month shots of Lupron for six years though for one year it was unavailable and I had Eligard. There was no difference in how they affected me. I switched to Orgovyx About three years ago, It’s a pill you take once a day. The benefit is that when you stop taking it, your testosterone comes back quicker.

2 1/2 years after my prostatectomy, my PSA hit .2 and I was given a 6 Month Lupron shot and two months later had Salvage radiation.

It’s good to hear your PSA has stayed the same. Normally when it starts rising while you’re on a leuprolide it will continue to rise because you become castrate resistant. Frequently they will put you on an ARPI when that happens a drug like Zytiga or One of the lutamides (like Darolutamide). They can bring your PSA back down to undetectable. I’ve had prostate cancer for 16 years and been on ADT for eight years. The last three I’ve been on Orgovyx and Darolutamide And my PSA has stayed undetectable for the last 27 months.

The American Society of clinical oncologist (ASCO0 recommend that you have salvage radiation if your PSA hits .2 after a prostatectomy. In your case, it sounds like your doctor is doing the right thing wanting you to get a PSMA PET scan. That will tell whether or not the cancer has spread anywhere else in your body. Your PSA is a little low for it, but it still works if there is significant spread. If they find it as spread anywhere else, you need to see a radiation oncologist.

Just so you know, here is the recommendation For what to do after a prostatectomy when the PSA rises.

From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.

0.2–0.5 ng/mL:
Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.

0.5–1.0 ng/mL:
Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.

This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/