You said your pathology report said - "Gleason score of 3+5 and one pelvic node positive."

The question you may want to consider asking is, if I wait for my PSA to rise and image again, would it change my treatment decision...?

If the answer is no, then, consider going with your decision. If the answer is you want additional clinical information on where the PCa is before deciding.

The question is, would waiting cause harm. My sensing and my urologist agrees in my case, no, at low PSA numbers such as yours (and mine as you can see from my clinical history), waiting to get additional clinical data does not entail risk of the PCa getting out of control.. I was just below the threshold he and I had established, .5. to image. We agreed to wait for one more PSA test, it came back at .7 so it met our criteria, three or more consecutive increases and between .5-1.0.

If your decision is to treat now, understand you have systemic disease and monotherapy, a single ADT agent, may not be the answer. Do some homework on doublet and triplet therapy, given your pathology report, one of those may be a good decision.

If you and your medical team decide to do radiation, strongly discuss and consider not just the prostate bed but the entire PLN system. and how high up the treatment field will be. If you wait for additional imaging it may change the radiation treatment plan by providing specific sites where the treatment plan could include boosts and wider margins to those, but it should still treat the entire PLN system.

Kevin