Posted 10/5/2012 7:42 PM (GMT -6)
I had a Gleason 9 with negative margins. Even so, many oncologists push for adjuvant radiation, maybe adjuvant HT, and some even adjuvant chemo.
My surgeon at Cleveland Clinic told me that the current thinking then was to wait until PSA rose. Because I took 8 months to achieve continence, I decided to wait.
I did 3 month ultra sensitive PSA testing, which remained at <.01 for 15 months, then slowly stated to climb. At 3 years it hit .06, and I initiated IGRT, at a a point much lower than many, but I felt that .05 was the BCR trip point.
There are no hard and fast rules in this game. Many doctors feel they have to recommend adjuvant treatments for liability reasons, but the hard data does not really prove much. Each case is different, so it is hard to say what would transpire if you didn't do adjuvant, or what will transpire if you do it.
I have begun to look at my treatment selections as time extenders. I got 3 years from surgery. Hopefully I can get 3 or 4 years from the radiation. At that time, I will most likely do HT, and continue until the HT stops working. Hopefully by then, the Zytigas or MDV 3100 drugs will be perfected. As a Gleason 9, I have concluded I will never be cancer free.
With your husbands numbers, I would probably consider waiting, but there are those that think I am crazy for waiting with a Gleason 9, so my opinion is suspect.
So glad you came out of the shadows and joined us. Sorry you won't find absolute hard answers. Google is a wonderful tool, and you can read volumes of data, but in the end, you and your husband will have to follow your hearts.
Good luck to both of you.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9 Da Vinci, Cleve.Cl 4/14/09 pT3a NO MX,
Neg Margins, PSA 6 wk,<.03, 3 mo. <.01 (dif lab),
mo. <.03 , 6 mo. <.01, No pads, 1/1/10, 9 mo. < .01, 1 year .01, 15 mo. <.01, 18 mo. .01, 21 mo. .02, 24 mo. .03, 27 mo. .02 , 30 mo .02, 33 mo .04, 36 mo. .06. 37 mo. .06
SRT begun 6/14/12