@clevelandguy Dr Kwon seems to be in your camp; he doesn’t seem big on SRT based on PSA until you can see something on a scan - then he will treat THAT lesion.
But it begs the question: if you have a visible lesion do you have many more NOT YET visible and therefore, would not be treated?
In my own case, I wanted full pelvic SRT as soon as I hit 0.18 (6 mos Orgovyx as well).
My thinking was that hopefully - and that’s all we’ve got folks - any cancer was still in the bed and the nodes and I wanted to kill it before it left the immediate area.
If I waited and waited for something to ‘show’ on a PET scan (mine was negative at 0.18) maybe it would have made its way to a lung, a rib or some other distant area.
True, that can still happen, and then treatment will probably be SBRT - whack-a-mole - and ADT for a long time. Best,
Phil