Ed, in fairness, when any of us surgery guys chose surgery, we did not expect it to fail. But despite having a great surgeon, etc, it obviously does. Then when you have to make the SRT decision, you are looking at odds in the 20-50% chance of it even working, which sucks, but most of us still do it in hopes of being on the good side of those odds. Then that's it, folks, the end of the purely curative means.
Casey, again, not pretending to know more than a doctor or more than you, the but argument made to me by my own doctors about not combing HT with SRT, or jumping to HT immediately after SRT, had to do with the assumed risk, that at some point, you would become refractory to the HT. If used early, and it doesn't help, either on its own or with SRT, then its thought to save the HT till a much higher post-SRT failure level of 10-20. Doesn't seem to be any agreement on the actual number. HT is only going to slow down things for so long, so choosing when to use it, or use it and stop it for awhile, then restarting HT again, seems to be the educated guesswork of the doctor, along with the particulars of the patient.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,