Thanks to everyone for their opinions - I really appreciate the advice. I have also read about
three consecutive readings in the ultra-sensitive range as a possible trigger for adjuvant therapy. This may be useful for someone who has had a positive margin or a high Gleason grade, but I question usefulness at very low levels, near the sensitivity of the assay, with a Gleason of 6. Suppose I were to see a sequence of PSA levels <0.008, 0.01, 0.02, and 0.04 - would any oncologist recommend adjuvant therapy in my case? Probably not, but seeing that sequence would drive me nuts. I failed to mention that my PSA velocity prior to surgery was relatively low: < 0.4/yr. Also, I have had an excellent outcome on the ED front and would hate to irradiate the nerves unless absolutely necessary. You can tell which way I am leaning, but I would love to hear more opinions on this. I don't want unnecessary adjuvant therapy or emotional distress, yet I don't want to bet my life on filtering out information, either.
Age:45 (44 when diagnosed)
Father diagnosed and cured at age 52.
08/21/07: Diagnosed with T1c cancer
1 of 12 biopsy cores positive; 10% tissue
Gleason score: 3+3=6
PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)
10/19/07: da Vinci prostatectomy by Dr. Vipul Patel
Difficult surgery due to prostate inflammation.
Both nerve bundles spared.
Spongy erections began within 24hrs of surgery!
10/24/07: Catheter out; down to 1 Serenity pad/day next day.
Final pathology: neg margins, no capsular penetration,
Gleason 3+3=6, 5% tumor involvement, multi-focal.
11/04/07 First usable erection with Cialis
11/22/07 Thanksgiving - Bye-bye, pads
01/17/08 First post-surgery PSA result: < 0.008 ng/ml
03/17/08 Erection quality mostly back to pre-surgery levels with Cialis;
have not tried without meds yet.
04/23/08 Second post-surgery PSA result: < 0.008 ng/ml
07/30/08 Third PSA: 0.01 ng/ml