@trtupper
You should’ve had salvage radiation a long time ago. It should be done when your PSA hits .2 and yours hit 1.6. Where are you being treated? Something is wrong with your treatment if they are allowing you to have such a huge rise In PSA without being treated. You need to get a second opinion from a center of excellence, Actually, not a second opinion you need to change your place of treatment if they have anything to do with treating you after you’ve had this huge rise in PSA.

3 1/2 years after my prostatectomy, my PSA started rising and hit .2. At this point, my medical team put me on a six-month shot of ADT (Lupron) Followed by two months later eight weeks of salvage radiation. That is the standard of care.

At a minimum, you need a PSMA Pet test immediately to see if there are metastasis that can be zapped and Thus reduce your PSA significantly.

You also probably need to be on hormone therapy ADT, Which will reduce your PSA to close to undetectable pretty quickly.

If you tell me where you live, I might be able to recommend somewhere to go for treatment, Do not delay this you are facing the equivalent of a firing squad.

Here is the recommendation from the American Society of clinical oncology for what you are supposed to do when your PSA starts to rise after a prostatectomy.

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/