My husband had very similar pathology findings - pT3a, cribriform plus IDC. His tumor burden was very small but enough to push his 4+3 pre op. to 4+5 post op. since he had those very aggressive features present inclooding specs of comedonecrosis.

We insisted on talking with RO and MO as soon as pathology was revealed and on doing ultra sensitive tests every month since surgery (which was also in August 2025). We seriously considered having adjuvant RT (RT done even while uPSA is undetectable) but were advised to wait to see if uPSA would start rising. His first uPSA was 0.014 and I can tell you without a doubt that if it was 0.1 we would have had that adjuvant RT.

When we had discussion with MO, he suggested to wait until (or when) uPSA reaches 0.05 and than seriously start preparing for so called "early salvage" and start it no later than 0.1.

My husband's uPSA is now at 0.026 and we are still doing monthly checking and if it continues to rise we will take MO's advise and start preparing for RT.

Regarding protocol - it will include whole pelvic floor and lymph-nodes and 6 mos ADT.

Hope this was of some help and I am wishing you super successful RT and forever remission after this step. Please keep us posted < 3