Hi Jeff,

I started to do the stereotactic therapy. From the PSMA-PET imaging, Ga68, there was a slight uptake in the obturator lymph node. 2.9, just above the 2.5 ambient. The pathologist wasn’t even sure it was cancer. The surgeon didn’t think it was but they treated it anyway. Three sessions of radiation therapy. 6 months later, my PSA went from 0.17 to 0.23. So, it still went up. Next PSMA-PET was negative. MRI negative. So, the radiation took something out. Not sure what it was. Surgeon thought it was benign.

So, now they are looking at treating the entire prostate area. Current PSA is 0.25. The side effects I was referring to were from the treatment. That’s my focus right now. Is it worth taking the chance that the treatment will cause unpleasant side effects, without success, or going untreated for the next 5-7 years without symptoms. Don’t know.

Most papers I’ve read say there is a 75% chance that the doubling time will increase. My doubling time is 15.8, based on the best fit curve for the PSA starting from 0.12. DT=ln(2)/m, where m is the slope. If that is the case then, I’m not sure I want to undertake the treatment.

Dr. Pat Walsh had some good comments about this. He said, if your GS < 0.8, your DT>15, and your time to recurrence is > 3 years, anything we do will not improve on that and will most likely affect your quality of life.

If I have the treatment and it’s unsuccessful with side effects or I don’t have the treatment and suffer the consequences, but later on.

By the way, how high does the PSA have to get post prostatectomy before you have symptoms, like bone pain?

I’m thinking that I’m already metastatic but probably still microscopic because the imaging is negative. So, maybe just wait until things go bad and treat it then?

I would really like to just forget about this stuff and get on with my life. If I don’t die from prostate cancer, I’only have about 11 years left anyway.

Thanks for your comments,

Lou