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1st PSA test seven weeks after surgery
Prostate Cancer | Last Active: Jul 25 3:06pm | Replies (44)Comment receiving replies
Hey Jeff, I am Gleason 9 (4+5) which is why I want to be more aggressive than standard of care. I talk to oncologist this Wednesday. I have my radiation simulation on Aug 20. This psa tested was exactly 7 weeks post surgery (49 days), but I had positive margins, PNI, EPE, SVI and LVI.
Replies to "Hey Jeff, I am Gleason 9 (4+5) which is why I want to be more aggressive..."
John Davis 60:
Yes it upsetting.
My 1st PSA post RP at Johns Hopkins was taken at 30 days and persistent at .19
Gleason 9 with EPE from Post-Op pathology.
So I was very disappointed with the pathology report and not stunned, but terribly disappointed, at the first PSA result.
My RO at Johns Hopkins prescribed Salvage Radiation to the whole pelvic region (WPRT) including the pelvic lymph nodes, together with ADT, and I chose Orgovyx.
I also had a PSMA Pet scan which did not reveal any specific tumors or areas of definite metastasis.
My radiation was IMRT 66.6 GY to the prostate region (45 GY to the pelvic lymph nodes), delivered in 37 txs of 1.8 GY each.
Tested 6 mos after radiation completed and PSA has been undetectable at < .02 for last 18 mos of testing.
Having surgery at 72 and then immediately having Salvage Treatment was a lot, however I am now 75 and feeling well.
So I empathize with you and wish you the best. And I hope and believe that your additional treatment will be successful.
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I can’t blame you for not wanting to wait. If you really want to jump on it, ADT plus abiraterone Is where they would go if you had Metastasis.
The thing is, If you go on ADT, your PSA will drop to nothing and if he does, you don’t really need a second drug. Something to discuss with your doctor, I think you’re right on the border of needing that second drug and I’m no doctor.
There are, however, some things going on that might interest you. If you want to stay castrate sensitive for the longest time than apalutamide might be an answer, There’s a study going on right now.