Looking for advice: Do I need Radition and Hormone therapy?

Andy,

Did you ever tell us your Gleason score, either from your biopsy or from your post-op pathology report? Hard to help you understand your situation without that. You mentioned a positive margin so apparently you have some information from your pathology report. Could you find your Gleason score for us?

Andy,

Your 3-week reading was way too early. It takes time for PSA to clear the system, and the reading at .4 was almost exactly what it would be just from the PSA half-life. 0.02 is below the level that predicts recurrence, and there is nothing to be gained by treating before PSA reaches 0.03. I agree with Andrew that the 90-day reading may tell you more.

- Allen

Andy,

Near the top of the screen there is a link labeled "My Profile" which leads you to a page with an "Edit Profile" tab the takes you to a page where you can enter your signature information (near the bottom of the page). It takes a while for the software to update so if your new signature doesn't show up during the first twelve hours try to be patient.

As for your question. As the tall one said that four week PSA was way too early to mean much of anything. Eight weeks is also sort of early but it would have been nice if it had come back "undetectable". If your next PSA isn't lower, and especially if it isn't less than 0.03 you might go ahead and worry. With your Gleason 8 disease and your rather high pre-op PSA you are at somewhat elevated risk and if your doctor decides it makes sense to treat it further it probably makes sense to be somewhat aggressive (ie. both radiation and a bit of ADT). But if your PSA keeps going down maybe you won't need to do anything.

This is whats confusing and quite frankly quite dangerous about this forum. The .03 trigger for treatment all started from a study Tall Allan related to us, which I read. The study was strictly relevant only to patients that were classified t3a post op. My memory fails me if it was t3a or more. When advice was given to this effect in the early stages of discussion on HW, this new" trigger" mention was always made with that caveat.This occurred maybe 6 mos ago, no longer than a year. Now, based on posts on this thread, not a mention of that caveat. So as the frog croaks in the heated water without a croak, the new trigger is slowly becoming the soup du jour at HW. We members need to take a hard look at ourselves and the way advice is parceled out. As one of my bosses back in the day aptly said. "We ain't packing tomatoes here" Granted we don't have the urgency of ATC, but we can at least
try to be consistent in our posts based on the knowledge we have. No more…No last. Its disturbing bordering on creepy in its laissez faire flair. Think about it!!

The issue is using only one criteria, psa, to determine reoccurrence. You have to look at the whole picture. Andy had a psa of 42 and a positive margin, both indicative of the cancer being out of the prostate. The risk he faces for a reoccurrance is much higher than your run of the mill surgery patient. Given the .02 reading, waiting for a psa rise is prudent, but the two negative factors must also be factored into the decision.

My apologies, I never know when to mention names or not. It was in no way meant to impugn you. I value your knowledge and presence on the forum, very much. I actually thought I had deleted that post after I saw Andy's signature of t3a. I must have misread the study and your subsequent posts initially after the .03 trigger first appeared here. I missed the positive margins or any adverse pathology in that. In reading anything, there is peruse, read and study. I practice all three and for that reason I wrote " we members " I see I inadvertently cancelled my cancellation, but may as well leave it, as another attempt at cancellation will only confuse the situation. As far as gibberish goes, like beauty, its all in the eyes of the beholder. I mean even the self descriptive word gibberish has meaning, as does/do any word/s regardless of placement, grammar, spelling or syntax,etc. I am more geometric than linear and most of what I do, say, or write reflects that. Its not for everyone and I make zero value judgements on those who it is not for. To each his own and to thine own self be true. Cliches are usually true and become trite because their repetitiveness dilutes their truth. This I find odd, because repetitiveness in most endeavors…surfing... most artistic endeavors... increase one's adeptness, not trivialize them. It is indeed a "devilish" existence… Tall Allan, be honest,... would not someone of my ilk be welcome{in the sense of valued not polite fully} at one of your algonquinish roundtables. Ya know, where you and friends gather for dialectic and interesting conversations?