Sorry to hear that Tom. So was this a first PSMA PET Scan you are referring to or a second one? If there was a previous one in the not to distant past, that would certainly indicate a pretty aggressive cancer. If instead you maybe had a less accurate MRI or Bone Scan, the metastases may have already been there but was simply missed, which is why the PSMA PET Scan is used. I say that only to keep you from going down the path that you're dealing with an extremely aggressive cancer. I haven't heard of anyone on the specific Orgovyx plus Zytiga combo, some of the newest line of approved medications. However, AR antagonists are commonly used with GnRH agonists to alleviate the effects of the testosterone surge that occurs with a GnRH agonist. And, I've read that extended AR antagonists may be used with GnRH agonists or antagonists to achieve combined androgen blockade (CAB). I expect they are looking for some of that synergy. I'm familiar with UFHPTI (Jax) so I know you're in good hands. I'm nearly the same age and am being treated at Mayo Jax myself. Best wishes!