So bad news for sure today.
So it seems my RALP failed out of the gate. I never reached undetectable. My ~3 month (around 11 weeks) PSA came back at 0.2, which is twice the 6 week PSA of 0.1. So not only did I fail my doubling time is like 5 weeks.
I sent a note to my surgeon at Fox Chase this morning asking to move my appointment up from 1/21 to something sooner.The Sloan Kettering nomogram for salvage specifically says "if you never got to 0, this nomogram is not for you". So I am not even sure what my chances of eradicating this thing are.
I am scared to death of ADT and I know its coming. I have been going to the gym to prepare for the battle but I am (very) overweight...although since surgery I have actively lost 30 pounds. On the bright side my metabolic panel looked great
My lipids were within range for the first time in like 10 years. My cholesterol was mostly under control. I need more of the "good kind" and my sugar dropped back to around 115 (last time it was 130). So the exercise and 1500 calorie/day diet are impacting!
Do I wait another month and get to a point where a PSMA scan can pick it out so they know where to specifically aim the radiation beam? Do I start ADT and do salvage when I become fully continent? Do I push for clinical trials where there are mixes of ADT, radiation and all of the fancy ADT and chemotherapies (just way sooner) I read about
here and elsewhere? In my note I indicated he should throw everything he has at it, including the kitchen sink if that helps. So he knows my mindset. I just cannot help but think this is my last chance to cure this thing.
I am definitely in a funk.