What your friend is getting is called "adjuvant radiation." That means he is getting radiation soon after surgery and without waiting for a PSA to make his decision. There have been 3 major clinical trials that proved that adjuvant radiation had better results than waiting until after an "official" biochemical recurrence happened (at a PSA≥0.2). But a LOT of patients would be overtreated by getting adjuvant radiation when they didn't really need it. And a lot of patients don't need it and would never progress. So, what to do?
One solution is called "early salvage radiation." That means waiting until an ultrasensitive PSA test indicates that a full-blown biochemical recurrence is bound to happen. For guys like you, with adverse pathology findings, that uPSA level seems to be about
0.03 ng/ml. Treating at a lower uPSA is often over-treating. And treating when the uPSA hits 0.03 reliably (97% of the time) predicts that the PSA will eventually rise to a full blown biochemical recurrence, and it gives you 18 months lead time over waiting for PSA to hit 0.2.How soon after surgery should salvage radiation begin?
This was confirmed at Johns Hopkins, although neither is a randomized clinical trial.Johns Hopkins: ultrasensitive PSA after surgery predicts biochemical relapse
You have nothing to lose by waiting for your first uPSA.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 9 yr onc. results
•SBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.2,no lasting urinary, rectal or sexual SEsmy PC blog