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Anyone had salvage radiation therapy post-prostatectomy?

Prostate Cancer | Last Active: Feb 5 10:22am | Replies (94)
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I would like to have "ALL" men chime into this response. I would like to know if this gentleman, and any/all other gentleman who had a successful RP surgery with documented "tumor confined to prostate, without Extraprostatic Extension (EPE) or surgical margins," later had biochemical recurrence of their cancer?
This gentleman's story is amazing to me that as a 53 year old man ( he is 68 and had the RP 15 years ago), he had the best chance to survive, disease free...UNLESS his surgical report said that he had EPE, surgical margins, and maybe seminal vesicle invasion.
I flat-out do not understand "how/why" men who had successful, tumor-contained-to-prostate" RP's without EPE and surgical margins, are coming back 10-15 years later with biochemical recurrence and elevating PSA levels. If there are any physicians on this blog, please contribute to this perplexing reality. And finally...
I ask this gentleman: Did you in fact have EPE and surgical margins, or was your surgery "clean" without EPE and surgical margins? Thank you

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Replies to "I would like to have "ALL" men chime into this response. I would like to know..."
Jeff Marchi | @jeffmarc | Feb 4 4:14pm

@rlpostrp
This may give you some information about this issue

Kwon and Moyad agree to this. Seeds for metastasis were already there when surgery was done, waiting to grow.

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wwsmith | @wwsmith | Feb 4 4:40pm

@rlpostrp EPE and positive surgical margins are large phenomena, easily observable by the naked eye. Cancer cells are microscopic and the first to escape the prostate gland will leave no noticeable indication that they have done so. That is why it is impossible at this point in time to know whether any particular surgery was "clean" or not.

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heavyphil | @heavyphil | Feb 5 10:22am

@rlpostrp Well, that is what all the ‘experts’ like Dr Kwon et al are talking about at all these seminars.
If your initial treatment was successful and 15 years later your PSA is rising, is it really BCR? If a PSMA is negative do you begin SRT anyway…or wait until you see something? And what if you wait too long??
It is truly exasperating!!
Phil

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