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The only answer to that question is the same as the answer to the question How long is a piece of string?" There simply is no answer that can be verified by a good study.
You will find that some men and their medical advisors would say that the radiation treatment should be commenced as soon as there is a measurable increase in the PSA, even if the test is an ultra-sensitive one. Others will say that if there are three successive increases that this is an indicator to start. Others will say "Let's see how it goes." - that's the view of my oncologist, who believes that i should not have any further ADT treatment unless or until my PSA hits 40.0 ng/ml again (I am of course in a different position to your husband because I still have a prostate)>
Years ago I came across TOM FEENEY'S site. Although it was last updated in 1999 most of what he says is relevant today and I think you might get a good insight into how he made his decision NOT to have secondary treatment after the failure of his radiation treatment. (If you go to the site, page down in the index on the left side of the page to About Tom Feeney). Tom has, sadly, passed on, but not from PCa. His death was a result of heart failure, the fate of the majority of us men.
You are facing a very difficult decision I know, with so many options. As ever, the only real advice anyone can give you - as opposed to information - is to do your homework and then do what you and your husband feel is best for you.
Pam: I can only tell you what course of action that was recommended to me under the same circumstances. Three years to the month after RP my PSA began to rise, what I would consider ever so slightly after 3 months from .007 to .011. The surgeon I have been dealing with strongly recommended IMRT and after consulting with a radiation oncologist, I decided to go ahead and have the 39 sessions done. The oncologist is Hopkins trained and had a very convincing arguement why, but once again, time will tell if it was the right decision. Many times I question myself "what if" as there are some drawbacks to radiation therapy. One of the main considerations was the 9 Gleason before the surgery.
I read this site every day and have never seen any wrong information but in the final analysis, it's what you feel comfortable with after seeking all the info you can digest.
Thanks Jack as you say, you just have to digest the information and try to come to the right decision for yourself - I suppose it,s just hard making that choice.
