Recent data suggests that after a recurrence there may not be a survival advantage to starting HT sooner rather than waiting until later after mets are identified. However, it was not a randomized comparison, they did not look at men who had salvage RT, and they only followed them for 5 years.Immediate versus deferred initiation of androgen deprivation therapy in prostate cancer patients with PSA-only relapse.
The other consideration worth discussing with your oncologist is whether you may have oligometastatic cancer that can still be treated with curative intent. Did you have an ePLND along with your RP and was it negative? There are several new PET radiotracers in clinical trials on the East Coast that may detect mets at lower PSAs and are more specific to PC than even the C-11 Acetate and Choline PETs currently in vogue. Because of the clinical trials, you can get them for free if you qualify. I wrote about
them in a recent post:www.healingwell.com/community/default.aspx?f=35&m=3271006