Phil,
Thank you for sharing your experiences with salvage radiation. I am so glad that it has worked out well for you. Two questions: did you have the radiation done at a “center of excellence” or a local facility. Was it IGRT or IMRT or proton radiation?
At this moment I am in a different “place” than in March, 2024. I am in “watchful waiting” mode. Following my last post (March 3, 2024) I have had the following PSA results: 3/12/24 0.9, 4/30/24 0.09, 9/28/24 0.11, 10/22/24 0.11, and 1/03/25 0.11. Based on the latest results (and having a Decipher score of 0.36) I have decided to just sit still for a while and see how this plays out. The decipher report says that, in my case, radiotherapy prior to a rise in PSA above 0.2 does not lead to improvements in the outcome. So, in the future I will be having PSA test every three months and when the PSA gets to around 0.2, and assuming my overall health is favorable, I will probably have salvage radiation. Because of the low PSA and the Decipher results I probably will not do any ADT.
My radiational oncologist and urologist tell me that they have not seen many cases where the PSA “stalls” for a significant period of time. They both speculated that perhaps the entire prostate was not removed but that is unlikely. Time will tell.
To people who see an increase of PSA after radical prostatectomy I would say that there are three important considerations: 1) your PSA doubling time, 2) your Decipher (or similar genomics tests) results and 3) the actual value of your PSA. My feeling is that you treat aggressive recurrent cancer at a low (lower than 0.2) PSA and you treat recurrent cancer that is not aggressive at a higher level of PSA (perhaps, even a bit above 0.2). I must emphasize that I am not a medical doctor and those are simply my opinions based on what I have read.
Thanks again for sharing your story with me. I will write a continuation of my “journey” when I start salvage radiation.