I am 8 months down the road after the robotic. I have a bad margin like you. This is a very hard personal decision to make. You should do just as your Doctor says and I even recomend meeting with a regular oncologist. My Doc said they now recomed seeing a Oncologist and radiation oncologist as a matter of protocol when there is a bad margin. Many here in our situation have decided to radiate adjuvantively while others watch their PSA's very closely and consider salvage radiation if their PSA goes up measurably. I am the latter.
My Urologist who is also an oncologist, recomended if he was in my shoes he would watch and wait based on what he saw. My margin was a single margin and very short. Radiation Oncologist stated that maybe at most two cells could be left behind. There is the rub, two cells can cause alot of problems or die off. No one knows.
I think about my decision alot, alot. My PSA's were undetectable at 6 weeks, 3 months and 6 months this I was told is a positive thing.
If you choose adjuvant ratiation, which I dont blame you one bit indeed, they would not be able to start radiation until you heal adequately which can differ from man to man. But for sure no sooner than 3 months. You should be able to see at least your 6 week PSA and your 3 month.
I believe that adjuvant radiation is administered in lower doses than salvage radiation.
I wish you all the best in making your decision. Knowledge is power. Do what's right for you. Do some research on positive margins. A good sight is UroToday.com. Its free
Diagnosed @ 53 years old now54
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
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate
Seminal vessels clear, fat tissue clear
single positve margin measureing less than 1/2mm
Six week PSA < 0.1 , 4 month PSA <.05 Gen II test. 6 month PSA <0.01
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 in 3 months lets see in 9 months.
Next PSA January 2009.
11-08-08 (7months) starting to go without day pads, 100 mg Viagra seeing good results