Was up late into the night thinking through all my options and possibilities. Here is what I came up with, my wife is 100% on board with my thinking. If any of you think I am misdirected or shooting myself in the foot, please speak up freely.
The radiation oncologist wanted me next Monday to come in be marked for radiation. Not.
I went to my urologist/surgeon's office and set up another PSA to be taken on Aug.11th. I wanted it there because all of mine have been done there since last August, even drawn by the same nurse, and always at the same lab. I want some consistency to make a decision and thought it wise not to switch labs in the middle of this.
I will meet with my urologist surgeon on Aug. 18th, to discuss the latest PSA, and to let him know about the two pathology report stories. Didn't mention today on purpose, as it wouldn't prove anything, and didn't want any bias on their part.
I re-scheduled the "marking" visit with the radiation center for Aug. 19th, the very next day if it proves it is still needed.
Post surgery PSA is sitting at .11.
Let's see what the next one shows (it will be at the 9 month mark), if it is still at .1 or let's say no higher than .15, then whatever is going on is going on super slowly. If has risen much more, then off to radiation I will go with a clear consicious.
It will also give me a month to get other opinions, or another look at the pathology report, or both.
Salvage radiation is the 2nd bullet in our gun for surgery patients, and I don't want to waste it or use it if not really needed. If I do, I won't have anything left if it ever comes back with a vengence.
Even the rad. oncl. dr. said waiting a month or two wouldn't endanger my case, so I want a little breathing room, I don't want to react to this out of either fear (me) or pressure from either my urologist or the radiation center.
I think this is a good compromise. If it goes up some more, then so be it, then I will be sure. If not, then some "watchful waiting" after the fact may be in order.
I have made all the arrangements with the appointments, so this is it for me, for now. I can only hope I am right in my thinking.
David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes
First PSA Post Surgery 2/9 .05, 5/9 .10, 6/9 .11
Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions