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Robotic surgery in June by a good doc with over 500 robotic surgeries. Cancer was a 3 + 4 =7 on Gleason in one area. All went well. Nothing in margins. NO lymph nodes removed.
3 months and the first followup shows PSA of 0.00
6 months and PSA is 0.05
9 months and PSA is 0.1
I'm concerned. Doctor is not alarmed about this. Am I just a worry wart or ???
If PSA moves to 0.2 or better at 1 year followup then is radiation a good direction for a fix??
The doctor probably is concerned but he doesn't need to do anything until your PSA hits above 0.2 and then he knows exactly what the next protocol is so no point in worrying until then (far easier said than done).
Yes, once it hits 0.2 then they will want to give you salvage radiation and 6 months of hormone treatment. I had it, and for the most part, it felt like going to a spa for 33 days in a row with weekends off. I did get hot flashes about 4 months into the hormone treatment and that was the worst part for me because I had trouble getting a decent nights sleep. I had no problems from the radiation during or since. After 6 years I still have an undetectable PSA and my PSA went just about like yours after my prostatectomy.
Robert. Sorry to hear of your distress over the issue. Of course that is perfectly normal to be upset, not much one can do about that. It is something to take seriously of course. Your initial PSA was super after the operation. It is too bad it is coming back up again but NOT the end of the world by any means. You have a good chance of good outcome yet. I had similar results though my pathology was more serious than yours with positive margin and one sem. ves. involved. Initial PSA was 0.09 and rose to 0.12three months later. Had salvage radiation one year later which knocked PSA to 0.07 at the latest. Your odds appear much better. Radiation is a serious treatment but is a walk in the park compared to what you have been through already. Go for the IMRT or better if they have better by now and do as they tell you in prep each day before going in for the least amount of collateral damage. Now is the time to hit it, it won't get better on its own. Being healed from the surgery is a plus at this point.
Robert:
It may take awhile to determine whether or not you are experiencing a recurrence As you undoubtedly know close monitoring of your PSA is vitally important. Worrisome indicators are steep inclines and/or a rapid doubling time. If and when you are diagnosed with a recurrence, your treatment choice may be as difficult (and as important as) your initial treatment decision. What you decide should be determined by the location and nature of the recurrence. Possibilities include a highly localized tumor (e. g., limited to the prostate bed), multiple focal points or systemic PCa.
Chances are your doctor is correct and you have nothing to worry about. Even so, it may not be too soon to begin a research effort. I documented my agonizing struggle with a rising PSA in an on-line journal. You may find some of the information contained therein helpful; see http://protondon.blogspot.com/ For your purposes a good starting point would be my entry titled "To My Family, Friends and Cyberspace Buddies." If you decide to take a look, I will be available to answer any questions that may occur to you.
