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First, the major markers for further action are primarily coming from the postop pathology report. Is there any cancer found in the lymph nodes, is there any seminal vesicle invasion, or is there any positive margin from the surgery? In any of these cases there are good grounds for taking further action.
Assuming good news on all the above risk factors then of course the post surgery PSA becomes the primary indicator. Perhaps your urologist arrives at the 0.4 number because that number has often been used in research as the level where bio-chemical failure is defined.
In any individual case I think an examination of all the factors of the case would probably be necessary to suggest a time and point for further action. Do keep in mind that even a 0.1 PSA represents the amount of PSA that is produced by millions of cancer cells. And consult with another specialist if you are not fully in accord with what you are hearing from your doctor.
A recent US publication identified more than 200 definitions of failure for the treatments of PCa. From this you will gather that, unsurprisingly, there is no consensus among medical practitioners as to when to start salvage treatment (or which salvage treatment they should recommend).
If you enter the words non-decrease in PSA in the Search Engine for this forum you will find a lengthy exchange on the subject of post-operative PSA which may be of interest to you.
