I had a very similar diagnosis late last year with RALP in February 2026, then monitored psa post RALP psa rising to .2 in about 10 months. Urologist recommended Salvage radiation therapy but then PET scan showed slight spread to pelvis. Urologist recommended Orgovyx and Nubequa with local radiation for pelvis node. I then decided to go to Mayo for a second opinion sharing all my data for their review. It was a good experience for me. They validated the proposed treatment plan and even complemented my urologists summary diagnosis. This gave me great comfort moving forward. 3 months later PSA is near 0 and testosterone continues rapid decline. Fully engaged in diet and exercise and new lifestyle it offers. Keep charging!