Some of the questions in here were questioning whether salvage radiation was needed at a .2 PSA. I emailed Dr. Abel Asking about whether salvage radiation made sense or should people wait. She replied within a half hour. Here are her thoughts on the need for salvage radiation when the PSA hits .2 after a Prostatectomy.

Thanks for listening to our talk. Dr. Madan and I both are in favor of salvage RT and recommend it to eligible patients. I would not usually factor the doubling time into a decision about salvage; it is more a question of how high the chance of cure with salvage is.

The initial studies for salvage RT in BCR patients were before PSMA PET scans, which may help better identify which patients are most likely to benefit from salvage than just the PSA value alone (example - if the PSMA pet detects small lymph nodes with cancer beyond the radiation area, then salvage is not going to be curative).

Our studies and recommendations are for patients who have either had salvage or declined to do it, where the goal of therapy is no longer focused on a potential cure. Most of our patients come to us when PSA begins rising after salvage therapy.