We need to play the long game.
RP at 72, postop pathology confirmed G 9 w/ EPE (margins, lymph nodes, seminal vesicles clear).
However, 1st 90 day PSA .19, which is called Persistent PSA as opposed to recurrence or BCR (no matter).
Radiation Oncologist txd short term ADT 4 mos, with almost 2 mos of radiation daily to the whole prostate area (WPRT) and pelvic lymph nodes.
1 yr post tx, PSA undetectable at Quest Labs sensitivity of < .02. Now 74 yrs old.
So I am grateful, but dread each 3 month uPSA test.
The Drs used to tx our high Gleason and EPE (or ECE) with immediate Radiation and ADT (adjuvant therapy).
Now they prefer to wait about 6 mos for prostate area to recover from surgery, and initiate tx at or around .2 (which level also allows possible detection by PSMA PET scan).
Many thoughts and comments; almost too many for msg board, but...
Your next tx, which might be years off ?, would be the Salvage Treatment protocol.
While the probability of our G 9 or 8 NOT recurring is small, I would have been happy with a period of years before I needed "Step 2".
Now I worry about what comes next for me as step 3 (have an idea, but do not like prospect).
There is a theory that seems to have evolved that removing the prostate, or mother ship, in the absence of discernable metastases, may delay BCR (or the need never arises).
So "keeping your powder dry" seems like is a good place to be to me.
PSA testing level is an interesting conundrum.
A Salvage Treatment friend at Johns Hopkins is being tested to the .1 level. My JH Rad Onc is testing me with the uPSA. Another RP friend receives the "Super low" testing to 3 digits.
Yes, I share your desire to know if my PSA rises at all, and above the < .02 level.
But I don't know why.
My layman understanding is that the Drs do not treat at less than .2 currently.
So if my PSA rises to, say, .03, I will "lose my shit", but i do not think that there is a tx protocol at that level.
I sometimes wonder if I should test only to .1 since ignorance (as opposed to stupidity) is bliss. But I am sure that I will not change.
My friend with the ultra low testing (my words) goes nuts when his PSA fluctuates from .006 to .007. Really ! ?
So my thought is to try to take solace in the "undetectable " reading and know that there is a Salvage Treatment available when needed. Maybe there will be something new or improved if we can get a few more undetectable years behind us.
I think that we need to embrace our current low PSA numbers and, as difficult as it is to do, enjoy the time we have w/o treatment. Have confidence that there is a next step.
I see so many on this site fighting with 3rd, 4th and more stages of treatment and try to embrace the blessing that is my current status.
Best to all.