@animate
I was in a similar position to you except my PSA stayed <.02 for 2 years after my prostatectomy. My pathology showed Gleason 7 3,4 with 4 being 30%. My tumor volume was 30%, had cribform and EPE and pt3a. My lymph nodes were good but to areas were questionable and Sloane said it went to the bladder neck.
When my PSA started up and it got to .18 I was told I would need SRT. They sent out a sample out at this time for a decipher test and it came back at .92. With it being that high they told me I needed 6 months of ADT also. I got the second opinion from Sloane Kettering and they recommended the same. The only difference was Sloane uses SBRT for 5 Sessions versus URMC uses IMRT for 38 sessions. I currently have been on ADT for 5 month’s Orgovyx and have completed 20 sessions. I am currently 72 years old and am doing radiation hoping for a cure. I do not like being on Orgovyx, it affects me emotionally and mentally. I am tired and it makes me weaker. There is no question that physical activity helps, it takes away the tiredness but my legs give out when skiing longer runs, there are days I get on my elliptical and I get a hot flash overheating and my legs are dead. Other days I am ok doing my 30 minutes. I was working out and doing 3 mile walks prior, I have learned to do more frequent walks with less length. The mental part is a little better as I am on drugs to help it. I am glad I will be getting through the ADT and can get back to the way I was.
You should get a decipher test so you have more data available to you.
Because I have hypersensitivity in the pelvic area I was told that adt may be the better option for me getting “vacations at times” or I could wait and see the PSA go higher. I chose radiation because I want a cure even though it could trigger extreme pain which they are using drugs to control. After being on adt which changes me as a person I am glad I went this way. And if adt in any way might help me cure it, I would do adt for the six months. I am counting the days to June 18 when I finish adt and radiation. The radiation has only caused me diarrhea so far which is a minor issue to date.
Wishing you the best and happiness always.