The Phoenix definition of biochemical recurrence after prostate radiotherapy (PSA nadir + 2 ng/mL) has served as the standard for two decades because of its simplicity, reproducibility, and correlation with clinically meaningful outcomes. This editorial highlights advances in PSMA PET imaging that now allow detection of local or oligometastatic recurrence at PSA levels well below the Phoenix threshold, creating opportunities for earlier salvage interventions that could meaningfully delay ADT initiation and disease progression. Of course lowering PSA thresholds risks overdiagnosis so landing on the optimal value may prove tricky. The authors advocate for defining biochemical recurrence beyond a single fixed PSA cutoff and rather incorporate baseline risk factors, PSA kinetics, imaging findings, genomic classifiers, and emerging biomarkers to create a more personalized early detection framework. | Terlizzi, Int J Radiat Oncol Biol Phys 2026
