Nearly three-quarters of patients with biochemically recurrent prostate cancer remain free of metastases 5 years after prostate-specific membrane antigen (PSMA) PET/CT-informed salvage radiotherapy (sRT).[1] Biochemical recurrence after radical prostatectomy is defined as an increase in PSA from zero to 0.2 ng/ml and affects a third of patients.[1][2][6] Clinical recurrence develops in 53% of patients with a PSA of 0.2 ng/ml.[1] BR defined as PSA ≥ 0.40 ng/ml with further increase best predicts the development of metastatic disease.[1] The dynamics of PSA growth is more important than the absolute value; A PSA doubling time (DT) greater than 1 year implies a lower risk of death within 10 years.[1] A PSA DT of less than 3 months is associated with a higher risk of death from prostate cancer, with a median death of 6 years.[1] Repeated PSA elevation was noted in 43 of 148 (29%) patients followed for 8–42 months.[1] Salvage radiotherapy gives the best results at PSA 0.2–0.5 ng/ml.[4]