@pcscott I'm so sorry to hear that, and it's very much in line with what the study @jeffmarc shared ended up recommending: that it's still important to do imaging, even when PSA is low or undetectable on ADT + an ARPI. I'm glad they caught it.

If you don't mind my asking, was your PSA undetectable on the ultrasensitive test (e.g. < 0.01) or the regular PSA test (e.g. < 0.1)? I'm asking only because I have not yet been able to find an example of the former in the papers I've read, while I have found (a few) examples of the latter.