Eastham and Zelefsky are world-class.
Regarding those who started initially on AS but eventually metastasized, keep in mind that generally these are the type of cases which also metastasize after surgery or other treatment, too...the risk is essentially the same. Unfortunately, there are a very small percentage of cases which essentially cannot be stopped…regardless of treatment. This reality gives rise to the well-known quote”
"Is cure possible? Is cure necessary? Is cure possible only when it is not necessary?"