Biochemical recurrence almost 5 years after RP - how urgent is further treatment?

It is true that if the PSADT is rapid, the prognosis is worse. That's why one wants salvage radiation before the PSADT gets rapid, indicating that it may have metastasized and is too late to cure.

If he's not convinced that salvage radiation is the answer, he is probably addressing a different question than that study or my article. The question I am answering is whether there is still a way to cure it. If he only wants systemic therapy, the question he is asking is whether there is a way to manage the disease without radiation. Certainly, he can manage it for a long time with hormone therapy alone.

Hi Annie, good to meet you, sorry we both have to be here, but I'm sure your husband is also grateful for the research that you do for him.

I've been back in research mode for a few months now, and I have definitely been reading that early chemo is better than later chemo, and I was advised by a researcher that my husband had been lucky to get into the clinical trial, though we have no official results yet, as these trials go for over 10 years before reporting.

That's also the problem I have with Standard of Care, it's based on treatment results from 10+ years ago, and there is lots happening in this field since my husband was first treated 5 years ago!

The slowness of his PSA rise is really encouraging to us, suggesting the cancer is not as aggressive as it was before primary treatment with chemo and ADT before surgery. Even the RO we consulted in May didn't feel it was super urgent to treat, his suggestion was to wait until autumn to start ADT, then radiation in Nov. He did order more frequent PSA testing, so that if there's a bounce before then we'll act sooner.

I do know that there are situations where an aggressive cancer mutates and produces less PSA, so we can't be complacent, but I've been unable to find stats on how common that might be!

To answer your question, we've not been to a PCRI conference before, but I did order the videos from the 2016 conference and have watched them all. Very useful information on advances in imaging, radiation treatments, chemotherapy plus hormone therapy. Need to find out what is available in Canada and costs if necessary to go to USA for any of it, but at least the conference is affordable and will arm us for further discussions with the doctors here!