Hi EHA1, welcome to the forum, to wait for symptoms or your cancer to spread will seriously harm your chance of cure, I know your PSA is high but your PCa is contained and treatment now would have a very good chance of cure, As you had radiotherapy 8 years go to have it again is unlikely though maybe SBRT or brachytherapy is possible, long with focal therapies - HIFU and nanoknife, and there's also a prostatectomy to consider, these treatments are not available everywhere so be prepared to travel.

Eddie

Thanks Eddie. At ho time has my oncology team suggested any alternative to hormone therapy and I asked another hospital about nanoknife and they said is was inappropriate for me on account of earlier RT (possibly my age is a factor (certainly that eliminates prostatectomy). But my current doctors are adamantt that my PCa is NOT curable and are fixated on hormone therapy and won't even talk to me about alternatives. I'm very grateful for your advice but reply in this way to keep the thread going for a while.

Localized prostate cancer means all the cancer cells are still contained in the prostate. I have no idea why they would say your PCa is not curable, PS modern radiotherapy treatment SBRT is possible if you had EBRT some years earlier.

Eddie

Warm thanks again Eddie, I will pursue your suggestion of SBRT and also seek a second opinion generally from another hospital..

Your welcome, can I ask is your decision regarding hormone therapy due to possible side effects

Yes. My situation is unusual because although I am 91 I am still carrying a lot of responsibility for running a family company and two charities which involve keeping  accounts and dealing with legal and pastoral matters. One of the charities is a small baptist start-up church where I share the preaching with a younger man who is himself a cancer sufferor. My chief issue with hormone therapy is "brain fog" and forgetfulness, although I have seen two close friends undergoing hormone therapy one of whom died within two years and the other has had to give up driving because of mental effects. The fact that hormone therapy, once started, offers such a variable and unpredictable life-expectancy is also a problem since my pension income helps to support both charities. 

Hi EHA1, can't argue about the brain fog, CRCC is it's medical name I know most people don't get it but many don't like to talk about it either though I am happy to talk about my experience of living with it, I'm fine driving but short term memory can at times be an issue especially remembering names, though my cognitive psychologist put me on his memory and concentration classes which has helped. My best wishes to you with whatever treatment you choose.

Eddie