Here is what my oncologist told me. There is statistically no difference in recurrence rates between negative margin and a single positive one. I also read that margins less than 3 mm are not significant. Finally, while contravecial, there are studies that show no difference between adjuvant and salvage radiation outcomes, as long as PSA was undetectable post op and salvage started before a certain PSA (I don't recall exact number - 0.3, 0.4, or 0.5).
Bottom line - there is nothing to be depressed about
. If you PSA post op is zero your chances are great! Focus on your recovery!
Father died from poorly differentiated PCa @ 78 - normal PSA and DRE
5 biopsies over 4 years negative while PSA going from 3.8 to 28
Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8
Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)
PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60
RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins
PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27
Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug