I will have my second anniversary for Da Vinci surgery in Septmeber. From a side affect standpoint I couldn''t be happier with the results. I have had absoulutely no issues to date. However, the most important factor is cancer control and this is where I am struggling with my results.
My pathology report showed Gleason 3+3 and was classified T2a with 15% involvement in one gland. There was no definite capsular penetration but the pathologist made a note that is was close and needed to be watched. My doctor told me it was probably close in that area due to the surgical procedure where he may have nicked the capsule. Anyway the report was disappointing at the time and continues to be a concern.
My first post surgery PSA was .04, my doctor delclares it undetectable at < .04 so I retook the test at four months post op and was indeed undetectable. I have basically been tested every three months since surgery and have bounced between undetectable and .04 with the exception of my latest test which came back at .05.
I was curious if anyone else has dealt with this type situation over an extended number of years and whether you are still under the recurrance standard of .2. I have also read that the biggest downside to the Da Vinci method is that it leaves more prostate tissue intact than the open method and in some cases you don't achieve some of the super low psa levels you see with the open method but that this is not neccessarily a precursor to cancers return. This may be wishful thinking on my part but I am interested to hear others opinions and experiences.
I also feel that if I see another rise that I will probably go ahead and do salvage radiation and not wait to see if it goes to .2 and how long it takes to get there. I would be interested in your thoughts on this strategy as well.