Hello COA44

The use of active surveillance (AS) following BCR after prostectomy is an option that may be offered based on PSA doubling time and other criteria including post surgical pathology. The argument for AS versus salvage radiation is based on a growing body of evidence that suggests 33 to 50% of men with BCR following prostectomy are over treated as their recurring cancer was indolent or of low grade such that it would not have impacted their life negatively. The issue as you might expect is how to determine which of us have an indolent BCR based on the testing available.
It appears that you have been on AS for a couple years now post prostectomy. Did your doctor discuss the AS criteria with you ? It looks like you had one year of fairly stable PSA around .2 however it is now rising so definitely time to ask questions about treatment options. What was your PSA and post surgical Gleason score and decipher score? That would likely have been a part of any AS plan.

I bring this up as my surgeon is a big proponent of AS following surgery and BCR for some men with favorable pathology. This very topic came up last month on my one year prostectomy anniversary Telemed conference call. I asked my Surgeon what happens if I get a rise in PSA? He said based on the rate of rise and other factors he might likely recommend AS.
BTW , When I chose Dr Ahlering as my surgeon I had to agree to be part of his longitudinal study cohort. He is following UCI PCa patients for the next 15 years tracking their progress and one area of focus is exactly this topic of AS following RARP with a BCR.
Until stepping down last year to focus on research, Dr Ahlering was the Vice Chair of Urology at UCI which is a center of excellence.