Posted 1/29/2014 7:16 PM (GMT -6)
Rodger, sounds like both our doctor's are on the same page on this subject, should give you some assurance that it good advice. Starting radiation (SRT) at .20 is considered safe by many RO's, and there are claims that its effectiveness can still be obtained as high as .50, though that might be pushing the window. What my doctor feels, is that men that get pushed, or jump into SRT with readings well under .20, aren't really factoring in the natural risk of radiation. And again, if there's no PC in the prostate bed, then its hard to imagine wanting to take the risk at all. Especially (like in my own case), the radiation failed within months of completing the SRT. In my case, as its well known, extensive and permanent damage was done to me as the results of the SRT.
That is one re-do button I wished I could have. Felt pressured at the time, mostly because my surgery failed fast. My uro assumed it was because of one tiny positive margin, but my oncologist feels that PC cells had long escaped my prostate and prostate bed, perhaps even before I was ever diagnosed, most likely because of PNI. That's his professional opinion. He stated that he would have never recommended SRT to me in the first place. A nice hind-sight thought, but way too late for this guy.
It's best not to get too worked up over minor PSA creeping, as then can lead to an unwarranted and hasty decision about SRT. It was explained to me, just how little cancer is really there, even with readings between .10 and let's say, .15. Not saying to ignore the creep, but keep it in its proper perspective.
Life is too short to get all wound up about such readings in my opinion, unless and when, there is clear evidence of BCR.
Yes, I have strong feelings on this subject, but I serve as a good example of what can happen when SRT goes very wrong. It's worse to me, because it probably wasn't needed in the first place, which makes the damage that was done to me "sting" even worse.
I still recommend SRT to any man that really needs it. All our primary and secondary treatments come with risks, we know that going into them. Just make sure one really needs immediate and additional treatments.
I hope you continue to do well, and that any creep is miniscule.
Age: 61, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA: Too High
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries