Crap, I thought I was cured.

Hi All,
My thread has been inactive for quite some time. I don't know if anyone will respond but I'll place this post none the less.
My two most recent PSA readings are yet again elevated. My current PSA is close to 2.0 above nadir, a fourth consecutive rise and it's clear I have recurrent disease.
A bone scan has revealed no metastasis and the reports on an MRI states:
"Areas of enhancement involving the right apex and right posterolateral midgland to base which could possibly represent residual or recurrent disease. No lymphadenopathy or other metastatic disease to the pelvis."

My oncologist is trying to get me on a clinical trial involving imaging using Gallium 68, a more sensitive scan in revealing metastasis.

I originally had seminal vesicle involvement which I know is a common prognosticator for future likelihood for metastatic disease, but until proven otherwise I am of course hoping for the local containment shown so far in my MRI.

I am at a fork in the road but the road is covered in fog. Without a clearer picture of whether or not I have metastatic disease I'm not sure what to do.

Even if I have some distant metastasis is it not wise to locally treat the disease in the prostate with salvage therapy?

My PSA doubling time is around 3 months. Not great I know.

I have had both IMRT and brachytherapy.

After radiation, any clear advantage of one salvage therapy over another if I choose to go that route?

Thanks,

Michael