@jeffmarc We frequently hear of guys that have a biopsy with 3+4 and then an RP later shows them to have 4+5. So then a year later the 4+5 guy starts to show rising PSA values. He could wait until the traditional 0.2 level to start salvage radiation or he could act early and start radiation treatment maybe at 0.1 PSA. But whatever PSA level he and his doctors decide to start salvage radiation, they know that he had an aggressive 4+5 case, so wouldn't most RO's recommend ADT for that salvage radiation case no matter what PSA level they began the salvage treatment?