@jeffmarc - Hi Jeff. My treatment plan followed all guidelines. Believe me, I checked. PSMA PET scan 6/6/25. ADT/ARSI 6/7/25. IMRT to prostate 10/2025. The L5 lesion was known to exist after the first scan last June but was minor and assumed would be contained by ADT. The error here is the conventional thinking that since my initial PSA increase in December was only 0.04, it was probably just irritation from IMRT or a lab variance. That thinking is flawed and the point of this discussion. I had been on ADT for 6 months at that point. My PSA should not have gone up. Noone, including myself, expected castrate resistance in 6 months. Had I insisted on a follow-up PSA test in January, I'd be in a different place now. Once the March PSA of 8.80 turned up, and confirmed two weeks later in April, it triggered the PET scan and MRI and treatment plan that could have been triggered 4 months earlier. My major concern, at this point, is how fast moving and aggressive it is. The timeframes for major changes are measured in months instead of years like they normally are. Additionally, since my prostate still exhibits active SUV uptake, radiotherapy resistance has come up in conversation. I guess we'll see after I get zapped next week.