What to do

Coachdg3,

Welcome to the board. 

In sequential treatments due to recurrences, usually after surgery one does radiation and after that it is hormonal (ADT). This is what your doctor is recommending, however, if the situation permits, there is the possibility in aiming  another sequential with the intent of cure named Oligometastatic Treatment. This can be done before starting ADT without prejudice to the efectiveness of that treatment because ADT is paliative and can be started at any level of the PSA.

Please read these links on the issue;

https://www.urotoday.com/library-resources/advanced-prostate-cancer/114375-oligometastatic-prostate-cancer-treatment-of-the-primary-tumor-and-metastasis-directed-therapy.html#:~:text= Oligometastatic Prostate Cancer – Treatment of the,tumor. 8 In this entity, the... More

https://www.birminghamprostateclinic.co.uk/prostate/treatments/oligometastatic-prostate-cancer/

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32598-4/fulltext

https://grandroundsinurology.com/new-considerations-for-oligometastatic-prostate-cancer/

To certify if one's case is proper for such oligometastatic treatment one needs to identify and locate the metastases as these must lie at appropriated places (PET scan with PSMA isotopes), in areas that were not previously radiated. Body tissues have a limit on absorbed radiation which restricts the rads intensity.

Your PSA is still low so I recommend you to read about the matter and check on possibilities with your doctor.

Best wishes,

VGama