Lou, you’ve gamed it out pretty well as far as I can see. I never really relied on doubling time because I felt that it could always change and possibly accelerate - yes, I am a pessimist.
There was one interval in which it almost doubled in 3 months and that bothered me, but then it held fairly steady for about a year before going up steadily in the last year.
I am 70 and fairly active and healthy so I could see myself living long enough to get metastasis; that was the basis for my decision.
Maybe at 75 my decision would be different but I cannot say. You are certainly being realistic with your 5-7 yr life expectancy but there are so many unknowns in the equation it could be much longer…or not.
Another way to look at it is this: most recent studies show that post surgical PSA’s up to .7 may not even need ADT, so in your case you have over a year to reach that number, IF your doubling time remains the same.
Also, your outcomes from either treatment at PSA’s of . 25 or .7 are the same, so why not wait? Not medical advice, just another perspective. Best,
Phil

When you look at your four options, they’re missing a lot of choices. In most cases, recurrence does not result in any side effects from The cancer. It can take years before damage is done to organs that causes side effects.

It is more likely that your PSA will go up and you won’t notice any side effects. What you want to do is keep monitoring your PSA, And base your future treatments on what your PSA does and what a PSMA Pet scan shows.

At the PCRI conference a couple of weeks ago they discussed the fact that salvage radiation only works with 1/3 of people the other 2/3 have cancer somewhere else. A couple of the doctors recommended waiting until the PSMA PET test actually showed metastasis and then use SBRT to zap it. Dr. Scholz Said that this has resulted in remission in a very high number of cases. The PCRI conference is available on YouTube, If you want to look at some of the latest information on what’s going on with prostate cancer.

I had Salvage radiation 12 years ago 3.5 years after my cancer came back following surgery. At that time, there really was no other option, Besides waiting. The salvage radiation did give me 2 1/2 more years with undetectable PSA, but it’s come back three times since then.

Did you get genetic testing to find out if genetics could be a factor. Does anybody else in your family have cancer? You can get it here for free, takes 2 to 3 weeks to get the results and a genetic counselor will call you.

Prostatecancerpromise.org

Don’t check the box that you want to have your doctor involved or it will greatly delay the test.
The reason you want to get genetic testing is that getting prostate cancer could be due to genetics. If you have BRCA2 for example then surgery may be the best place to start.
With a Gleason seven you have a good chance of getting treated and being cured.