Following my surgery, despite the pathology I received my surgeon made no mention of whether adjuvent therapy was advisable or not. It was not till about
8 or 9 months later, following research, that I understood there was an argument for it being done as an precautionary addition to surgery. There have been quite a few studies that have pointed out the benefits of adjuvent therapy where there were doubts on margins. This is usually carried out at about
the 3-4 month mark after you have well and truly healed from surgery. By taking a PSA at about
6-8 weeks you will establish a baseline PSA and then taking a couple of PSAs over the next 3 months may give you an idea of anything going on, allowing early intervention with additional treatment. My only concern when I read your details was that your first PSA was scheduled for what I thought was 4 months post surgery. Should this have a small reading then further PSAs over the following months would be needed to establish what was going on.
To me this is the real benefit of the ultra-sensitive test. But we are all different in how we react.......some don't want to know about
testing and others want to know what's going on to the Nth degree.
But having said all that if you look at my case............. looking back, because of my pathology there was a very good case for adjuvent therapy being carried out, but as I have to date been undetectable at the ultra-sensitive level, it would probably be judged now, again with 20/20 hindsight, as being unnecessary. Then again, should I ever relapse, salvage therapy is still available. That's the trouble with this bloody disease.
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01
PSA August 09 (2 year mark), <0.01
My Journey: www.yananow.net/Mentors/BillM2.htm
Post Edited (BillyMac) : 11/9/2009 2:08:03 PM (GMT-7)