Clinicians should offer observation or clinical trial enrollment. Clinicians should not routinely initiate ADT. Clinicians may offer intermittent ADT in lieu of continuous ADT, if ADT is initiated in the absence of metastatic disease Clinicians should utilize PSMA PET imaging preferentially, as an alternative to conventional imaging due to its greater sensitivity, or in the setting of negative conventional imaging. (Expert Opinion). This evidence concerns the gene FOLH1 and metastatic neoplasm.