Ed C. (Old67) said...
Steve, welcome to Healing well. I am a Gleason 8 guy, I had robotic surgery on 2/2009 at the age of 67, fortunately my PSA remained undetectable until 2017 when for the first time it was .01. since 2017 my PSA kept creeping up and it is now .12. I plan on seeing an oncologist to plan the next step. With your high Gleason it will be prudent to follow the surgery with Adjuvant radiation to make sure that co cancer cell are left behind..
Following RP with adjuvant RT is not standard of care for high-grade disease unless (1) there is persistent PSA post-op or (2) there are one or more adverse findings in the path report. I haven't seen a single treatment algorithm from a major institution or a published paper that recommends prophylactic adjuvant therapy, whether RT or ADT, when there is a pT2 outcome with negative margins. In other words, any decision about
the need for further treatment waits until after surgery.