I contacted the Royal Marsden when there was some doubt about a lymph node of mine beeing infected. (By three hospitals to one it was subsequently thought this was not the case). However, due to the possibility I asked the Marsden if they would connsider treating me with Cyberknife which they have and was told they would need to consider this in the light of the paths my original RT was delivered. So this supports what I said previously and also what Lyn said. I think the conclusion to the linked article is relevant "In the absence of strong evidence, treatment should be personalized, established by agreement with well-informed patients, and the patient circumstances and preferences should be taken into account."
Rich has had a PSMA scan which has produced findings but is does not, because with present technology this cannot be determined, identfy micro mets even should there be some there. It seems to me that Rich might do well to use his forthcoming meeting to discuss with his Oncologist, not only what is suggested now but alternatives that may be suitable at some stage to stop or slow advance. So this might include other possibilities such as radium 223 and immuno therapy treatments at appropriate time.