Thank you. I think urologists have a "wait and see" mentality because prostate cancer grows slowly: "Nothing will change much in three months." But..."growth is growth", "spread is spread", so why do they wait? They push the RP surgery on you right away, but then knowing they didn't get it all and that there are surgical margins and the rest of your pathology that has now likely shortened your longevity (EPE, Cribriform glands, seminal vesicle invasion, maybe bladder neck spread), it is suddenly: "let's wait three months to see what your next PSA is, and then we can 'talk about' radiation." Meanwhile, you read accounts here on this Mayo blog, of patients being taken to radiation therapy immediately after surgery whether they had the ominous pathology features or not, and well before they even have their first 3-month post-op PSA.
This "industry" needs better standards of care. Every clinical discipline that spans the entirety of our health and lack thereof, has what are called "Standards of Care." Physicians, Nursing staff, Quality Assurance, and others, get together at conventions and seminars, then back to their own facilities to establish how they will diagnose, treat, and cure everything that is within the sphere of a certain disease. There are currently Standards of Care for Prostate Cancer, but it seems they vary significantly from physician to physician and region to region across the country. The more I read this blog the more I am convinced of it, and confused by it.