When using active surveillance for rising PSA after prostatectomy, at what level of PSA would you start ADT?  

In the absence of metastatic disease to nodes or bones, my management of biochemical recurrence after prostatectomy usually consists of observation or intermittent ADT. Of course, it is important to make sure the patient has received (or has been given the opportunity to receive) salvage radiotherap...

I agree with many caveats. The PSA level of 10 is quite arbitrary and in older studies from Hopkins, the median PSA at the time of metastases using conventional CT/bone scan imaging is around 30, and of course, is much lower with Axumin/PSMA PET imaging. However, this does not mean that earlier use ...