@clevelandguy The rational is that when you are treating at these very low PSA levels you are treating micro metastatic disease. The beds and pelvis area are likely locales. The risk is that not all or any of the micromets is there and you have been treated unnecessarily. However, the rest of the body is also being treated with ADT. That is for the whole body not just the bed and pelvis and studies show it provides additional benefits to delay or avoid mets. So yes it would be great to wait and see it but the numbers discussed above do not support that approach. They support treat early. Also seeing something to treat is not a panacea as there could also be other sites of not visible micromets. There is no easy answer but as someone with adverse features I want to get treated.