Surgery Nov, 14 2014 Negative margins, negative lymph nodes, negative vessels
Radiation Nov 2018. PSA was .13... later, it was .10, then .08, followed by .11 and now .16
Not to cause undue concern, but I would say it appears that the chickens have already flown the coup. Unless there has been a clinical lab error (and they do occur) your PSA appears to be rising post-ART, and the thing to do now is monitor and graph the rise - assuming it continues to rise, determine your doubling time and choose a path forward from there.
... even when PCa appears to be prostate confined, tumor cells in circulation may have taken hold and formed micromets in other tissues, e.g., bone or distant lymph nodes long before treatment. It is hypothesized that these micromets may explain clinical recurrence when there was no evidence of disease even for decades after primary treatment for prostate-confined cancer.
Genomic testing ... can help in decision-making regarding the pelvic volume to irradiate with primary, adjuvant, or salvage RT or the addition/duration/timing of ADT.
As Howard has already had SRT, future Tx will basically be chemical, unless solid mets become established and visible on future scans. As for genomic testing, if you are willing to pay for it, and your doctor is willing to recommend it (mine never are nor have been) then I suppose it may have some value, once you have embarked on a new treatment plan, based upon your DT.
The risk of micro-mets having already escaped from an extracapsular tumor or the SV is why I fought like hell
to get my ART underway within a year after RP... which included numerous complicating events, and extended my Lupron for an additional eight months post-ART, to wrap up any post-RT cell divisions. The result has been uncomfortable and life-altering, but hopefully has put the PCa matter to sleep long enough that I can focus my attention to the cancers of my two sons.
Next blood draw in two days. Hopefully both PSA and T will remain low. Good luck to you Howard.