Sorry you are here but glad you came. We are very similar in ways. Here is what I can add. I too have a positive margin at the apex or top of prostate by the urethra. I did not find any information that lead me to believe that it is worse or just unusual. My Doc was surprised to find it there for it is usually lower. Any way here is what I did. I got real nervous and then I got my six week PSA. Zeros good. Next I was to set up to see the Oncologist then to see a Radiation Oncologist. Oncologist stated to be safe and increase my odds do minimal external beam radiation. The radiation oncologist stated I could go either way but if it was him he would radiate. My 3 month PSA was less than zero again. I finally found out the length of the positive margin. Pathologist stated less than .5mm. Maybe two cells left behind worse case.
My Urologist/Oncologist who did the surgery stated that he would do active surveilance and if the PSA even blinks then radiate for sure. He thinks the bad margin may have been from the handling of the gland itself. Surgeon to nurse and nurse to pathologist etc. He also stated that the positive margin does not mean that it is for sure on the other side of the knife but at the edge. They consider my cancer encapsulated. Surgeon stated sometimes left over cells can just die when the prostate is no longer there.
I will have a PSA every three months and pray and live my life as good as I can in between. Remember nothing is going to be done before 3-4 months if you decide to radiate. You need time to heal and get stronger. There is no hurry here so you have plenty of time to ask your Docs a zillion questions like me and do research and do research as so on.
Its very hard for you now for you are still early in recovery. Believe me as you get better you will relax and be able to better focus on this.
My email is listed if you want to go direct with me.
All the best,
Diagnosed 01-08-08 @ 53 years old
DRE normal , 2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
PSA @ surgery 6
Bone and Ct scans negative
clinicaly Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,Hospital stay 30 hours - Catheter out in 7 days normaly expected leakage Erectile function better with Viagra
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate, Seminal vessels clear, fat tissue clear,Tumor on top of prostate. 1 positve margin measureing less than .5 ml at urethra and bladder..
Six week PSA < 0.1 , 4 month PSA <.05 Gen II test. Urologist recomends to hold off on Radiation and watch PSA closely. Oncologist and Radiation Oncologist seem to lean to doing pre-emptive radiation.Uroligist says 50/50 chance of PSA re-occurence.
I have decided to hold off and see for 3 months.
Next PSA October...