@brianjarvis ❝PSMA PET scan results will typically show little while on ADT. The lower the PSA, PSMA PET will be “essentially negative.”❞

Yes, that's part of why I'm not getting PSMA-PET right now for routine monitoring. With my PSA undetectable (< 0.01) on ADT+Apalutamide for 4.5 years, it might not show much. Instead, I get a combo of bone scans, CT+contrast, and MRI+contrast, all of which could show growths regardless of whether they express PSA (and even, god forbid, if they're a different type of cancer developing), even though the resolution is a little coarser.

(The other reason is that PSMA-PET is used much more sparingly outside the U.S., since there's little evidence yet that it improves overall survival or progression-free survival, despite its finer resolution. I could ask for one if I had biochemical recurrence — my PSA started rising again — but it's not a routine thing.)

@brianjarvis Yes the topic came up indirectly in the sense that they would be monitoring PSA and doing PSMA as indicated if the PSA hit certain points. They will still do PSA and such if I chose radiation now but then that signal would not exist for a while.