@animate That’s good that you previously had a PSMA PET scan that showed something; that means that you (probably) aren’t one of the ~15% that are PSMA-negative. (It’s “probably” because even within one person, some prostate cancers can be PSMA-positive, and some not.)

Yes, the results of a PSMA PET scan can impact how treatment is managed.

As for ADT helping or hurting you, isn’t that the way it is with every aspect of prostate cancer diagnosis and treatment? Everything seems to hurt and/or help. But, prostate cancer is a bad-ass disease, and you have to hit it appropriately the first time - not too soft or it’ll come back; not to hard or you risk serious side-effects (that might even be worse than the cancer itself). Finding that “Goldilocks zone” is the goal. For me, ADT fit into that “Goldilocks zone.

My proton radiation treatments (April-May 2021) were my primary treatments. Prior to that, I was on active surveillance for about 9 years. So, I had plenty of time to look into all treatments and pick the one that fit my priorities the best.

There really wasn’t much to recover from the treatments. My wife later told me that if she hadn’t known I was undergoing radiation treatments, she wouldn’t have realized it from any change in me. And the short amount of time that I was gone each day for treatment were no different than any other time when I simply left to go shopping or to the gym.

I had minimal side-effects from the ADT due to the low testosterone - just mild “warm” flashes, significant muscle atrophy (w/about a 30% loss of strength), and my libido went to zero (but, never had ED). When testosterone returned, all those side-effects subsided.