The fact that you are a solid G9, and at almost 2 years out, reporting a .02 is an amazing stat in itself. You are so far under even a basic <.10 reading. By PSA number alone, you are doing great.
In your case, any radiation would be Salvage, not Adjuvant, but that's not even the issue.
There are so many cut-offs, and our clever ones can cut/paste the "truth" on the subject, but I have heard so much variation in the past 2 plus years from a plethora of good doctors local to me.
The trouble with nanoograms/charts/percentages/stats - they are just a collection of numbers, not specific to anyone in particular. With our cancer, each case is so different, one reason we get different answers to common questions. Doesn't mean flaky doctoring, just meansdifferent patient specific information.
My uro/surgeon was deeply troubled with my first post surgery PSA of .05. In his long experience, he knew that there was potentially cancer left, especially dealing with a high velocity patient. He was right, had BCR well under a year, and that being a Stage 2 Gleason 7 case with one tiny positive margin. Would the warning of .05 mean anything to anyone else? Probably not, unless you had similar path.
When I was interviewing 3 different radiation oncologists and 2 medical oncologist (one was my former from cancer 10 years back), independently, they all thought a reading of .05 was not a good sign, either being post surgery or post SRT. Just so many factors to consider.
After my infamous and painful dealings with SRT this time, the doctor said that any upward movement of PSA, no matter how slight, was already early evidence of failure of the treatment. My last reading, though small, was up a full 50%. When I get my next reading in late February, it will be real interesting, as it will have been a full 6 months instead of 3 months, there is no reason for me to expect that there won't be a big jump at that time. Oh, how I want to be wrong.
For you guys that are G8 and higher, as long as you can pull the low numbers, the longer you dont have to use your second curative card, radiation, I think (not a qualified opinion) I would hold off, enjoy the better pre-radiation quality of life you have now, especially with any lingering ED and/or incontinence issues. Just because you have bad pathology, doesnt guarantee its going to turn bad anytime soon. Sure seems to work opposite the way our logic looks at it.
In the end, its not looking at charts and percentages, its having a good working relationship with quality doctors, and working as a team, between patient and doctor. A good doctor is looking out for your best interest, I believe that in my heart.
David in SC
Post Edited (Purgatory) : 1/23/2011 11:29:32 AM (GMT-7)