The correct and most honest answer is, that no one including doctors or any tests at this point will be able to determine the exact source or
location of the cells that are producing these trace amounts of PSA.
This is what my own doctor's told me when I showed evidence of reoccurance.
Radiation, like I just completed, works on the assumption that it is still local to the prostate bed. If the cells are all contained there, then there's a high likelyhood that the radiation will kill off the remainder. But there are no guarantees. Stray cells can easily exit the prostate bed through blood vessels and nerves, etc.
In my own case, I had one tiny positive margin. My dr. felt that one margin was "good" bad news. She said it made it more likely that the cancer was in the region of the positive margin, so when she designed and mapped the IMRT for me, she based it all around the positive margin.
Did the radiation get mine? Jury is out, way too soon to know. Will have my first post radiation PSA drawn late in December, that will give me a new base to compare to.
I already agree with your doctor. If a second PSA test shows more increase to you, and I hope it doesnt, then you wouldnt want to wait indefinintely to begin some form of radiation. It would be jumping the gun in my opinion if you insisted on it know. My drs want to see 3 numbers in a row rise above .10.
Good luck to you.
David in SC
57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.33rd Biopsy
: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3Open RP:
11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09Path Rpt
: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence: 1 Month ED: Non issue at any point post surgery
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped 9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place