June 2025 Update on my journey. Been quite awhile since I posted. Here I am 3 years after RARP, non-nerve sparing surgery. Only surgery, no other treatments. Now a young 76.
Pathology post the May 2022 surgery showed:
Prostatic adenocarcinoma, Gleason score 7 (4+3), with multifocal extraprostatic extension. (EPE is high risk marker)
Margins, free of tumor.
Seminal vesicles, free of tumor.
Histologic Grade: Gleason score 7 (4+3), grade group 3, percent pattern 4: 70%.
Intraductal Carcinoma (IDC): present (fast growing cancer another high risk marker)
Cribriform Glands: present
Pathologic Staging (AJCC, 8th edition): pT3a.
PSA numbers since surgery:
<0.008 June 2022
<0.008 June 2023
=0.01 Dec 2023
=0.14 Dec 2024
=0.18 Feb 2025
=0.21 May 2025 Biochemical Recurrence
Since the PSA is rising with a doubling time of 8 months, urologist recommended a PSMA-PET scan. Scan was negative but doc says at low levels like 0.21 not finding anything is common. Radiologist recommended doing something (SRT salvage radiation therapy) now so his plan is 8 weeks radiation IMRT hitting the old prostate bed and pelvic area which is the common area for recurrence. Read lots of articles indicating treat it early with SRT and possibly ADT. Very fearful of damage radiation can do and would like to hear from group.
Back to more decision making………