Interesting point of view. Fact is, If you have a problem, your PSA is gonna hit .7 pretty quickly. I know for me, just cutting back Zytiga from four pills to three caused my PSA to rise from .2 to 1 in 18 days. I went right back on four pills. Another example, in 2017 I got my six month Lupron shot late by two weeks, Same day I had a PSA test, My PSA had risen from undetectable to .6 that month, I was undetectable for the next two years. If you have a problem, it can go up quickly. I was a Gleason 4+3.

Have to admit It’s a good idea and must be backed up by a lot of data. According to AUANews however exceptions include “Other high-risk features include grade groups 4-5, PSA doubling time (PSADT) ≤ 6 months, persistently detectable postoperative PSA, and/or seminal vesicle involvement.”

The kicker for me is seminal vesicle involvement. Where we thought it was a problem, but to include that in exceptions, but not cribriform is interesting, and a little scary for some.

If they’re not waiting for .7 they are over treating a lot of people. I know that up till now that .7 has not been the rule. But I suspect there’s a good number of doctors that didn’t do ADT after surgery if it was just a Gleason seven. That’s what happened to me, though that was a long time ago.