What a great question!! I am keenly interested in the responses that you're likely to get here, so I'll be watching this thread very closely. As a "recurrent, high-risk, advanced, but localized and non-metastatic" patient myself, I am being consistently told that salvage surgery or further radiation treatments are out-of-the-question for me; that there are no other real or practical alternatives, other than returning to ADT treatments of some kind (e.g., Orgovyx, likely followed by Nubeqa).

Meanwhile, I'll hear from others that strictly speaking, this is not true, that SBRT, or other 'focal' therapies (Cryo or HIFU), may in-fact be perfectly possible, maybe even "advisable"? So for me, it's become pretty clear that obtaining sound, consistent guidance on the matter, regardless of professional credentials or source, is NOT as simple as 'walkin'-the-dog' or 'glue-on-a-stick'. It's actually proving to be a veritable "minefield"!

P.S. - I should also add that many of those who suggest the possibility of 'focal' or ablation therapies, often say that the duality of added ADT (in addition to SBRT, Cryo or HIFU), would likely still be recommended or required.