I think I've talked with you on the vets forum. Here's a bit more detail about
my medical experience following failed surgery and failed salvage radiation like you have had. Your PSA rise, both after surgery and after SRT, occurred faster than mine, so what your oncologist recommends for you might be different than white mine recommended for me.
When I first saw an MO at Dana Farber after my PSA hit 0.2 with a doubling time somewhere around 9 months his initial opinion was that since I had years between surgery and SRT and years again after SRT (see my signature) I would probably continue to have a slow rise in PSA. Based on my history he said he would be inclined to wait longer than he might with someone whose history showed more aggressive PCa and that he would base the decision on doubling time as much as on any absolute number. He thought probably not starting ADT before my PSA was over 5 or so - which wound have meant another 5 or 6 doublings and several years. As it turned out, my doubling time began accelerating toward the end of 2017. When my PSA was around 2 and my doubling time was hovering around 6 months he offered a chance enroll in a Prostvac vaccine trial. While I was going through all of the initial screening - CT, bone scan, EKG, lots of blood tests -- my doubling time continued to shorten, which ended up disqualifying me for the trial. Within a couple of months my doubling time was around 2 months and my PSA was over 6 by the time I cleared the screening for a different trial and started on ADT. Though I am in a trial, I was randomized into the control group, so I'm getting the same treatment I'd be getting otherwise, though with extra monitoring.
Your MO might recommend a different path for you. But if your PSA acceleration remains slow, maybe you can wait quite a while before starting ADT. I'd discuss options with MO.
-2002-PSA 9.4, 5 of 10 cores 30-50%
-RP 2002 PT3B N0 MX Gleason 3+4 75% left lobe small focus rt lobe
-PSA low 0.01 slow rise to 0.4
-SRT 2010 1 lymph node targeted. Casodex during SRT
-PSA 0.00 thu 2014
-0.02 Oct 14; 0.04 Apr 16; 0.2 Oct 16; 0.51 Jan 17; 2.46 Jan 18, 4.19 Apr 18;
-6.62 May 18 start Firmagon; PSA 0.45 Jun; 0.08 Jul '18; 0.02 Nov '18
Post Edited (Bohemond) : 1/8/2019 10:44:50 AM (GMT-7)