It is very worrying, and my husband’s case is similar to your husband’s. Since your husband completed his initial systemic treatment, some cells may be active but too small for the scanning. I would ask the oncologist if he should immediately go back on the ADT with a possible different second generation AR drug like Xtandi if he doesn’t want to stay with the Apalutamide again. If you don’t want to go back on the systemic just yet, you could repeat the PSMA PET after a bit of time and see where the net is and radiate it. There are so many choices. I am not sure if there is enough volume for chemo but I would definitely ask. Others will respond who are more knowledgeable than me, but I think he is likely still hormone sensitive, and you can maintain this like a chronic disease for years. That is our plan. Please let us know how you proceed. Best wishes!
Thank you Stephanie! We were promised a “chronic disease “ path too! I am hoping that is still where we are at! He is doing bloodwork again today and then we are seeing the MO and then following up with one at MSK at the end of the month. Best of luck with your journey!
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Axumin PET scan with undetectable PSA
My first post. Rising PSA After Surgery. 
Rising PSA after being off ADT for 16 months
Should I start ADT ?
