How long after radical prostatectomy did you see a rise in your PSA?

@colleenyoung Hi! Haven't seen him yet. Waiting on the PSMAPET this Friday. I think I see him the following Monday. :). Thank you for asking.

@chipe Best wishes! The radiation oncologists showed us the virtual images of the PSMA scan at the visits. I just sat there and was in awe of medical advancement. I'm thankful for this scan because in my husband's case, it can at least pinpoint where the recurrence is. However, like many other people here mentioned, the oncologists said that smaller recurrence (less than 2.5mm or even some that are about 0.5 mm) will not appear on the scan. I feel that this is like playing hide-and-seek game with these microscopic cancer cells. Definitely, it's more complicated to make decision on the most suitable treatment for patients, like my husband.

My question first followed by my reasoning and questions based on a bit of research:
Have any of you men who had the radical prostatectomy, been put on ADT after you started to show an increasing Biochemical Recurrence (BCR) of your PSA, whether you had radiation therapy included or not?
My questions/thoughts:
One thing that I am starting to see more and more of (little by little), is people saying that they will be starting ADT...but they have already had the prostatectomy. Dr. Patrick Walsh's book "Guide to Surviving Prostate Cancer" goes into a LOT of detail on ADT...BUT...he only mentions it for men who "still have" their cancerous prostates in them, and that the cancer is perhaps metastatic. BUT...he offers nothing on ADT for post-RP men, who have, say BCR or other cause to think that the cancer is returning. Even other literature refers to men with or with our metastatic cancer who all still have their prostates, and what their studies revealed for groups put on ADT with, or following, radiation therapy, and those who did not have radiation therapy. But again, there is no discussion about men receiving ADT post-RP. There must be a reason for that: It was not, and still is not, common place to do, at least when Dr. Walsh wrote his book? Thus my question above: Have any of you had the prostatectomy, and then, after the fact, with perhaps BCR showing recurrence, been put on ADT instead of radiation (or with it), or Proton Beam Therapy? ADT is no "take it at face value and accept the therapy" topic. You are messing with your brain...your pituitary gland and your testicles. MANY ill-effects and bad outcomes can happen, just like all of the men and women who attempt to transition their sex to the opposite of what they were born as. I appreciate any experience or knowledge you have about whether it is common place, or just starting to come into vogue to give ADT to post-RP patients.

@rlpostrp

ADT is part of the protocol for RT no matter if it is initial RT or salvage, or adjuvant. One can choose not to have it , but it is better to take ADT drugs in conjunction with RT, especially if one had any aggressive features in their PC report.

So...it sounds like you're saying that ADT is never done "by itself"...it always accompanies radiation therapy, with the idea of killing the recurrence a "one-two punch."

@rlpostrp

Well I am sure that in some advanced cases and in patients that are diagnosed at advanced age and that can not have RT or RP , ADT in conjunction with other "lutamides" and such are used as possible palliative treatment. I never heard of ADT being used "by itself" in otherwise "normal cases".

As a part of RT (initial or salvage) , it is started about 2-3 mos before initiation of RT itself.