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I had my prostate removed in Feb and went on Tuesday for results. Gleeson9 T3a PSA 0.5. Left side of prostate riddled with cancer. Been told have to wait 2 months and after results of Next PSA test before they will give me treatment. Is this usual to have to wait?
Steve:
There is a WHOLE lot more to the situation than just considering these numbers you provide. Your doctor(s) will incorporate all they know to guide your care. I think that finding a top prostate cancer oncologist is a first off activity for you, if not done already. Further treatment is likely with what you offer above, though timing is the question. The superb study SWOG 8794 can be Googled and it showed for men who were T3 post surgery, that radiation within 120 days was significantly important in improving their prognosis. These men did have undetectable psa after surgery. Thus you meet some, though not all, of their inclusion factors. There are certainly side effects for radiation, particularly after surgery so soon.
To answer your question, another psa is reasonable, after a short delay, to confirm and compare to the first before making any decision. You do not mention what treatment it is they are considering, if any. Healing from surgery is necessary, and resumption of urinary and erectile function, if possible, plays in with this decision. Margin status and other pathology factors must be considered. It is a complicated matrix.
The search for an oncologist with whom you are comfortable can be a fruitful use of this intervening time.
Steve,
I think tarhoosier has shown just the right attitude for you in this situation. One small note, a sizeable number of the patients in SWOG 8794 did have various levels of PSA remaining after surgery. There are further analyses of that study based on those levels.
Two large randomized trials (European Organization for Research and Treatment of Cancer [EORTC] trial 229111 and Southwest Oncology Group [SWOG] trial 8794) have now reported on the beneficial outcome of adjuvant radiotherapy in patients with pathological risk factors after prostatectomy.
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