pT3aN0Mx

G 9 w/ EPE
1st 90 day post-op PSA .19 (persistent PSA).

Prompt Salvage Radiation Treatment:
IMRT 37 txs (WPRT) 66.6 gy total prostate region; 25 of the txs included pelvic lymph nodes 45 gy

Difficult radiation proctitis last 4 wks of radiation
Short term ADT

No residual effects from radiation (routine colonoscopy; no radiation damage)

2+ yrs post Salvage Treatment; all uPSA tests have been undetectable < .02

In my opinion, you are fortunate to have undetectable PSA postop.

If, and when, your PSA becomes detectable, and a PSMA Pet does not identify any specific lesions elsewhere, Salvage Radiation Treatment is the next step.

The low dose per session/many sessions would be my choice vs fewer sessions and higher doses of radiation.

Short term ADT (SPORRT trial). Or no ADT, seems to be a developing trend.

What I believe that I have learned is that we are all the same; and all different.

There is no precision in prediction.

Either you receive SRT as quasi-adjuvant therapy currently or when/if PSA becomes detectable.

For me, I know that I have PCa and that it is highly probable that I will have recurrence in LESS than 10 yrs. Every uPSA test is worrisome. And that's the way it is.

Does not make it easier to accept. I have 2 friends who also are undetectable 2 yrs post tx following SRT at the same time as me (and no, I do not know all of their numbers).

A cancer diagnosis is a challenge to accept and live with peacefully, and I hope for all of us to be able to find that place of acceptence of our disease, and turn our energy toward recovery and disease management, including the mental aspect.

Best wishes to you and to all of us.