Biochemical Recurrence After Prostatectomy

In May of this year, 2024, I had the hoLEP laser enucleation of the prostate. I had to wait 1 year and 9 months with a urethral catheter for this procedure. They enter through the urethra, cut the prostate itself into sections, push those pieces into the bladder and then go in with another tube called a morcellator to flush with liquid and suck the pieces out. The CAPSULE, or shell, of the prostate, is left intact. The pieces of prostate, "the ultimate biopsy," is sent off for pathology.
Previously, I had an MRI that showed no presence of tumor. However the pathologist did discover a malignancy, rated at Group 2 with a 7 (3x4).
Two weeks ago, I had a PSA, the first one post op six months after, it came in at 0.911
I have been reading that anything above .2 is a biological recurrence. I am in Barcelona Spain, public health system, where the doctors are "accountants first" doctors later, i.e., bottom line.
My uro surgeon says you're fine, point 9. I mentioned that it should be .2 or less. He says, point 2, point 9, could be anything. I couldn't believe what I was hearing. He says: you're cured! I said, really? Well, that must explain the lower back and sacral pelvic bone pain I have been experiencing since a little before the surgery.
He shrugs it off. Then, he says that I'll need to come back again in six months for another PSA. (I already knew he was going to say this btw), so I asked why? He said to know for sure that we got all the cancer. Then I said, but if I am cured, why do I have to have anther PSA? He said it was routine for all men. So then I remarked that if I'm "cured" yet you need to make sure, then the cure statement is moot. You really don't know, hence the follow-up. I asked him to write out a partial prognosis that doesn't specify I'm cured, but doesn't diagnose me with cancer. He also added in discussion that it could be some "other" cancer, but either way, I will attend the follow-up- then he sends by email an invitation to prostate cancer seminar / group at the foundation where I had the surgery. I never asked for that, I signed up for it.
Is it time for a second opinion? From who? They all know each other. Opinions?

I am speechless. Cancer is bad enough without being treated by incompetents and liars.
Firstly, morcellators are practically outlawed in the US. They ‘grind up’ tissue and this allows any cancerous tumors to be turned into hundreds or thousands of cells, free to seed the entire body. I am not being alarmist but if you have the means $$ get on a plane to the US - or any country that practices current cancer care ( the UK?) - and get some form of treatment IMMEDIATELY.
You need PET scans, probably ADT to slow cancer growth and then radiation if possible.
Again, I know your anxiety levels are high and I don’t mean to make them worse, but you need help right NOW, not in 6 months. Best to you

I am speechless. Cancer is bad enough without being treated by incompetents and liars.
Firstly, morcellators are practically outlawed in the US. They ‘grind up’ tissue and this allows any cancerous tumors to be turned into hundreds or thousands of cells, free to seed the entire body. I am not being alarmist but if you have the means $$ get on a plane to the US - or any country that practices current cancer care ( the UK?) - and get some form of treatment IMMEDIATELY.
You need PET scans, probably ADT to slow cancer growth and then radiation if possible.
Again, I know your anxiety levels are high and I don’t mean to make them worse, but you need help right NOW, not in 6 months. Best to you

I’m on my second recurrence. I personally don’t believe that anyone is “Cured”. I believe that cancer goes into remission. I was in remission for 7 years the first time and then 2 years the second time. Now my cancer is growing again. The cancer cells are so small , that they can be anywhere and they could start growing again, which is what happened in my case. Just my opinion.

In May of this year, 2024, I had the hoLEP laser enucleation of the prostate. I had to wait 1 year and 9 months with a urethral catheter for this procedure. They enter through the urethra, cut the prostate itself into sections, push those pieces into the bladder and then go in with another tube called a morcellator to flush with liquid and suck the pieces out. The CAPSULE, or shell, of the prostate, is left intact. The pieces of prostate, "the ultimate biopsy," is sent off for pathology.
Previously, I had an MRI that showed no presence of tumor. However the pathologist did discover a malignancy, rated at Group 2 with a 7 (3x4).
Two weeks ago, I had a PSA, the first one post op six months after, it came in at 0.911
I have been reading that anything above .2 is a biological recurrence. I am in Barcelona Spain, public health system, where the doctors are "accountants first" doctors later, i.e., bottom line.
My uro surgeon says you're fine, point 9. I mentioned that it should be .2 or less. He says, point 2, point 9, could be anything. I couldn't believe what I was hearing. He says: you're cured! I said, really? Well, that must explain the lower back and sacral pelvic bone pain I have been experiencing since a little before the surgery.
He shrugs it off. Then, he says that I'll need to come back again in six months for another PSA. (I already knew he was going to say this btw), so I asked why? He said to know for sure that we got all the cancer. Then I said, but if I am cured, why do I have to have anther PSA? He said it was routine for all men. So then I remarked that if I'm "cured" yet you need to make sure, then the cure statement is moot. You really don't know, hence the follow-up. I asked him to write out a partial prognosis that doesn't specify I'm cured, but doesn't diagnose me with cancer. He also added in discussion that it could be some "other" cancer, but either way, I will attend the follow-up- then he sends by email an invitation to prostate cancer seminar / group at the foundation where I had the surgery. I never asked for that, I signed up for it.
Is it time for a second opinion? From who? They all know each other. Opinions?

That's what my oncologist told me. If you have a biological recurrence, especially that affects the bones, (which unfortunately I have) it can be a life long program of monitoring and treatment as needed. And be proactive. My PSA wasn't checked at my 2023 physical for some reason, and PSA was 30 when they checked it a couple months ago and now I'm stage 4.