Bob, for starters, no one here is an "expert" with PC. Some are more informed and researched more than others. So don't feel bad about
what you don't know, that's what your medical professionals are for.
While an upgrade from a 3+4 to a 4+3 is not what one wants, its not that uncommon. Yes, they are both Gleason 7's, but of course, in a 4+3 combo, assuming the pathology is correct, it is made up of more type 4 cancer cells, which are more agressive by nature.
As far as radiation plans go, thats the job of a radiation oncologist. Coming up with the "plan" is unique with each patient, and there are many factors they compensate for when determining how many treatments are needed, and at what amount (gys) and even how its delivered. Again, those are the things for the experts.
Just because a person has positive margin(s), doesn't mean its 100% will cause the cancer to recurr, just more likely. We have men here with no positive margins that have had recurrance, and men with positive margins that haven't. Such is the fickled nature of PC.
If I read your dates correctly in your stats, you haven't even had your first post-surgery PSA test yet. That should be coming up soon, I would hope you slide right into the Zero Club with a good reading.
The radiation oncologists I have met with, including the one I went with, don't like to start immediate radiation after surgery, until they see evidence of the cancer coming back. Some doctors do that differently, of course.
I fully understand your concern, as I am a Gleason 7 case with high velocity, and my surgery "failed" and I have recently finished salvage radiation, but dont worry your self sick at this point. You are clearly still in the post surgery recovery side. I will come back and post a few questions for 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, no problem post SRT
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one: July
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4, Caths #11 and #12 same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17