If you are post-prostatectomy, then the activities that I mentioned (bicycle riding and sexual activity) should not affect a PSA level. "Leftover" prostate tissue that was not removed during the prostatectomy ("surgical margins", likely from Extra Prostatic Extension a.k.a. "EPE"), that slowly begins to grow, will be your only source of PSA test value increases, and...very slowly over time, unless your pathology was such that your prostate cancer was deemed an aggressive form, despite your Gleason Score. My Gleason Score was Low Intermediate Risk at 3+4=7 with just 6-10% of cells being "4", but upon post-RP pathology review of my prostate tissue, my cancer was deemed more aggressive with left seminal vesicle invasion, Cribriform glands, EPE, and surgical margins that I mentioned. I went from being what my urologist thought would be a T2 at worst, to being a pT3b with near certainty that my cancer will return "within" five years...it might be this year, next year, two years, etc., but there is no less than a 25% likelihood of it returning. That is the mystery..."where" is it lurking...hanging out...if my prostate, both seminal vesicles, and both vas deferens were removed along with all vasculature that would provide blood supply to any remaining cancer cells. Exasperating...frustrating...and anxiety-ridden. So far, with two post-op PSA levels at 3 months and 6 months, my values have both been < 0.1 ng/ml ("zero"). Being a pT3b feels like I am walking around with a ticking time bomb on my shoulder...waiting...waiting...for it to tap me on the shoulder and say: "I'm baaack, and I'm going to kill you"... BOOM.
HI: @rlpostrp
I am exactly in the same boat as yours. 3+4 with only 1 out of 18 cores positive, but my final pathology report was similar to yours: pT3b disease. Both a GPS test before surgery and a Decipher test after surgery confirmed a very aggressive biolgy for my cancer. I will have my first post-surgery PSA next week and will meet with my surgeon the week after. Like you stated, there is no question about recurrence: the only question is where and when. Given that, I expect the main conversation with my surgeon will be: should we do a pre-emptive adjuvant radiation and/or hormone treatment in the coming months, or should we wait for the signs of recurrence and undertake salavage radiation treatment then? That is what I have been thinking about for the past few weeks: weighing the pros and cons of each approach with respect to both cancer containment and quality of life.