Did you start radiation immediately or wait until PSA was 0.2 ng/ml

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.

I was in the 2 hour ancan.org Advanced prostate cancer online meeting today. They were discussing Dr. Eleni Efstathiou who wrote that article? She is a really well known and a really great GU oncologist. They didn’t discuss the article you posted, they just talked about so many things she had done for people.. One of the guys in the meeting has her picture up behind him so you can see it while he is there (She’s pretty attractive). There are a few people in the Ancan meetings who live in and near Houston and go to her for treatment. She is great to talk with, and extremely helpful from what they say.

I did post the link to the article you initially posted, in the chat, during the meeting, so others could see it as well.

All I can say is that you have positive margins; you STILL have documented prostate cancer inside you, regardless of the surgery. What good was it if your surgeon couldn’t get it all?
OK, so you had a gross debulking of the tumor nidus, and a clear picture of what’s going on based on your surgical pathology report…excellent.
Your surgeon is completely useless to you now as a source of treatment. Time to consult an RO to treat the cancer still inside you before it gets worse.
If you are comfortable with waiting for the magical 0.2 PSA - mostly used in cases where the surgeon knows he ‘got it all’ - go ahead. Me? I’d be running…
Phil

Yes, we are trying to make app with RO at least, we shell see if that will be before December, knowing waiting period we had here from the beginning. We are calling another place but it is so hard to get info as outsider - like we have to "transfer" care to get information of how things are done. Some days I feel like I am a main protagonist in a Kafka novel 😵‍💫...

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.

I personally can't imagine getting radiation unless my doctor recommended it and I, again, verified it. Radiation isn't a preventative measure, it's a reactive measure.

I take a baby aspirin every morning, because with a family history of heart disease it was recommended. It has very tiny chances of side effects at that dose. Now, I could take a 500mg aspirin every morning instead of 81mg, to really supercharge that prevention, right? I would end up with ulcers, liver damage and all kinds of problems as I attempt to fight off something that isn't diagnosed or certain.

An apple a day keeps the doctor away. A bushel of apples a day gives you diabetes 😉.

100% true !!!

I can read new studies till end of times - until findings are part of "standard of care", they are useless. I can plead for MO to no end - my husband will not see him until all "boxes" are checked on scheduling screen.

Second point also true - every facility will push with what they have available and by a "big kahuna" (whoever that is at that particular facility). Staffing status and amount of funding will also determine of how patients are stratified .

So, waiting it is ... or not, if you have means or if you have luck.