The cost of medical care in the US are ridiculous. We paid over 20 k for research/biopsy/first treatment when my husband was diagnosed. Fortunately, he has insurance now but the travel to and from the US is also quite expensive and time consuming.
India has top notch private clinics, and we've found an urologist who is more than happy to work together with my husband's oncologist in the US. So his oncologist in the US decides on the treatment plan which is implemented by a private clinic in India. We will still check in the US from time to time, but not every 3 months.
B.t.w. his 3 months PSA was 0.7!!!!!!!!!!!!!!!!