My oncologist, radio-oncologist, and urologist all advised me to hit it as hard as possible and as soon as possible. They all advised that the IMRT, HDR and ADT should be concurrent (adjuvant) rather than sequential.
They all agreed they would expect a better treatment result by hitting the cancer from multiple fronts concurrently. They explained the ADT would weaken the cancer and allow the radiation to work better when used concurrently.
This is in line with the oncologists so often listed as specialists. I don't detect much "wait and see" or "wait until it can be felt" advise from Strum, Sartor, Meyers, and others. What I read about them is that they are active with treatment and not afraid to try different things if the response isn't what they hoped for.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010, HDR Brachytherapy 12-6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.