@tom86

I would kindly suggest that you do all of your research and be ready for BCR since there is always a lot of time needed to organize everything - from PSMA to MRI to getting approvals and deciding on a treatment and having appointments with RO and MO and having simulation done etc etc.

If we relied on DRs who went with their very relaxed pace, my husband who had fast doubling time would have started his RT much later than 0.2 which is a cut off PSA for achieving the best possible results.

So, you preferably need to have everything lined up and ready to START with RT at 0.2.

@tom86
The American Society of clinical oncology (ASCO) Recommends having salvage radiation following A prostatectomy as follows.

From Ascopubs about what PSA to do salvage radiation.

≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.

0.2–0.5 ng/mL:
Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.

0.5–1.0 ng/mL:
Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.

This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/