New Member

Welcome to the group. Best wishes on your next PSA test, hopefully you remain stable. But, good for you being proactive knowing that with your initial diagnosis that there is a strong probability of needing salvage treatment. It is best to be prepared and in the correct position if you need it. Hopefully your initial surgery proves to be curative, but as we know those G4 cells can be real pests.

Rockin - Your first post was very good and complete (except the part about Djin being the smartest person in the room ). You are a good student and you learned to appreciate your wife a lot more as I did after 10 miserable days.

Not much to add, your three month PSA is the defining moment as you know and that gives you permission to relax for three months until the next one. The 3 month testing cycle gets old pretty quick as you soon see. I just went to 6 month testing after 2 years and it is a relief.

The only questions I would have are 1) Do you know what the percentage of Grade 4 cancer was in your 3+4 pathology? and 2) Any thoughts on getting a second opinion from J. Hopkins/Epstein on your pathology just to nail that part down?

EPE and SM are negative factors and your Decipher score is a positive factor as you probably know so you have to keep that in proper perspective. Very good chance that your prostate experience will be peaceful for a long time.

Rocking, that is encouraging data. The only quibble I have is that if your PSA was done with a 3-decimal ultrasensitive PSA test, the actual written result that came directly from the lab would be 0.010 rather than 0.01 (perhaps a zero was dropped in reporting it to you.) But that is a quibble.

As you know, it is premature to talk about salvage RT for you! But (just to talk about it anyway), there are many factors that determine a "trigger level" PSA. Keep in mind that experts analyzing the three very recent studies that looked at adjuvant vs. salvage therapy for men with adverse findings after RP are leaning toward a conclusion that (at least for those not in the high/very high risk groups), early salvage therapy yields results just as good as adjuvant (and, of course, leads to fewer men being overtreated).

Your good Decipher results should give you some solace that any recurrence may well be non-metastatic and local, and therefore quite "zappable." Getting back to the various factors that can influence a "trigger" PSA, they include Gleason score, the number and extent of adverse post-RP findings, pre-op PSA, post-op PSA nadir, current PSA value, time since surgery that the PSA rise began (the longer the better), the rate of rise or doubling time (the slower the better), any genetic/genomic studies such as Decipher score, family history, and of course the results of any imaging. Plus whatever I've forgotten. I think this is why any doc is hesitant about setting an actionable PSA immediately after treatment.

Djin

Rockin, welcome to the forum. Good move on your part, meeting with an RO. Yes, its extremely early, but better to be set up if you do have to pull the trigger, so that you can get a running start and not be just beginning the salvage radiation process
Here's hoping it never even comes to that.

Thank you all for kind words, advice and information. Best wishes to all!

Got results today for my 3 month PSA test. 0.01, same as my six week test. Very pleased there's been no increase!

Hello, Rockin@57 ~~~

Really pleased you went from "reading" to POSTING here!

You've already found a ready welcome here, but I wanted to write a few lines today, to check in with you, and see how you're faring.

Summertime is here, and your surgery is now under the rearview mirror!

Hoping you are regaining in your strength, vitality, and vigor --- as the days go by.

If we had grown up in the same hometown, we would have been in school together ---as we are in the same age range.

I'm very pleased to see that LOW LEVEL P.S.A. score ---- that's great news, to be sure. Thankful to read your subsequent post, indicating P.S.A. stability.

That word has become one of my favorite words in recent years. Anytime my doctor says that things are remaining STABLE --- well, that's cause for a bit of a celebration.

Along the way, be sure to read the "LETTERS TO THE NEWLY DIAGNOSED" thread we have put together here.

We worked together as a collective team to put together a collection of letters that newly diagnosed members will find helpful, encouraging, and life-affirming.

It's evident from your posts that you have a forward-looking outlook on the future. You've got a positive spirit towards life, and a proactive approach to following up with your medical team.

A mantra that I like states, "I can't promise you everything is going to be easy, following a health diagnosis, but I can promise you that your due diligence is going to be worth it!"

Summertime is here ---- we'll keep the backyard firepit stocked with firewood, and we'll save you a seat in one of the Adirondack chairs circled around the firepit, for your next visit here, Rockin@57!

Check in again soon, and let us know how you're faring!

Handshake, camaraderie, fellowship ~~~
CYCLONE ~~~ # Iowa State University

Rocklin@57,
I was also 57 at Diagnosis, Are you from Rocklin Ca.?
Welcome to the club that none of us want to be in,
Great move to Huntsman Clinic, good on ya.
Here is a link to this Letters to the Newly Diagnosed that Cyclone-ISU started, some great inspiration and hope there:

https://www.healingwell.com/community/default.aspx?f=35&m=3675218

Wings aka Dan in Hot hot So Cal

Hello Cyclone! Next PSA test is in two days. While my PSA has been low since I had surgery in January I keep having the feeling the next test is going to show a rise. My RO said he believes I will need salvage radiation "someday." Retirement is great, not bored with being a lazy bum yet! Summer has been interesting in Utah. Extreme heat, Great Salt Lake is at historical low level, entire state is low on water, few rainstorms we've had have been huge and caused flooding. On top of that our skies have been covered with smoke from California's fires for weeks.