I just read Sonny's post and something there woke me up.
I went to the paper he posted and pulled out a couple of things.
"Adjuvant radiotherapy within 18 weeks after radical prostatectomy in a man with pT3N0M0 prostate cancer significantly reduces the risk of PSA recurrence, metastasis and the need for hormonal therapy, and significantly increases survival."
"More than 20 years after the initiation of S8794 this report demonstrates that adjuvant radiotherapy at the relatively modest dose used in the late 1980s significantly reduces the risk of metastasis in a man with pathological evidence of extraprostatic disease after radical prostatectomy. This significant reduction was realized despite the application of salvage radiotherapy, perhaps the most commonly used approach to these patients today, in a third of the patients in the observation group. Additionally, this reduction in metastases and improvement in survival occurred despite an almost doubled use of hormonal therapy in the observation group. It is important to place this outcome in perspective. The median 1.7-year survival benefit may apply to more than 30,000 men per year in the United States. In the realm of advanced prostate cancer docetaxel, the only treatment proven to improve survival, improves survival by only 1.9 to 2.3 months."
In addition to the most important outcomes of prostate cancer (metastases and survival), all other measures of disease recurrence were improved with adjuvant radiotherapy. For those men with an undetectable PSA postoperatively the median delay in time to PSA recurrence was substantial at more than 7 years."
My PSA was 23 pre-surgery, and 0.04 at 13 weeks. I took that to mean I was ok - or as ok as can be expected.
However, I did have an Extraprostatic extension and there was extensive perineural invasion
My Pathology stage was pT3aN0MX
At my 3 month check up with my surgeon, I asked if I should do anything else, and the answer was "No. We will monitor it. See you in 3 months" I did not seek another opinion. Being the cynic that I am, I figured if I went to a Rad Onc he'd recommend Rad, etc. The system is geared to pay for services.
This makes my worrying about pee pad and pen*s performance seem trivial. (I'm not called Worried Guy for nothing.)
So, is 0.04 undetectable or not? Should I rush out and find a doc as the 18 weeks is fast approaching?
What do guys with similar stats do?
DX Age 56. First routine PSA test on April 8th: 17.8.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7 Tumor size: 2.5 x 1.8 cm location: both lobes and apex. No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Extraprostatic extension present; Perineural invasion: present, extensive
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 10/31 3 months, Still no activity, nada, zip
Incontinence - 8/20 4 full pads per day
. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
9/17 2 months: Still 3 pads per day.
10/31 14 weeks: Still 3 pads per day. At this rate I'll be fine in 2012.
Post Surgery PSA - 9/3 6 weeks- 0.05, 10/13 3 months- 0.04 undetectable.