I'm unsure if my IRE nanoknife focal therapy was inappropriate? Perhaps yes and perhaps no. After much reading and being afraid of both surgery and radiation, I sought out a place that might offer focal therapy. At a Philadelphia center of excellence I was told that I was a good candidate. Having 4+3=7 gleason with tumor being only one side of the gland and after several tests including PSMA PET scan which showed no metastasis they told me I was a good candidate. The procedure went well and was confirmed effective by both imaging and biopsy 7 months later. Unfortunately, another 6 months later due to a rise in PSA another PSMA PET was performed indicating metastasis in pelvic lymph nodes. Doctor opined micro metastasis that was not picked up in earlier PSMA PET. I was definitively disappointed but I don't regret taking a chance at it. After which there wasn't too much of a decision process. ADT + ARPI + 40 sessions of IMRT which so far has been effective with PSA being <.05 consistently over a year. Anyhow do you think in my case this was an inappropriate decision by me and my Urological Oncologist?