@heavyphil
Huh - you would think !!!! Now all of the sudden we should wait some more - for one more PSA next month *sigh

You know all of that "personalized" approach for high risk patients is just an empty gibberish, it seems. Somebody somewhere decided that BCR is at 0.2 and that became magical number - it is "standard of care" and one can argue their little frighted heart out and point to papers that say that HR patients need to have extra early salvage (between 0.1 and 0.2 ) but : "we are still not even 0.1 " - I mean yes BUT, if this doubling time continues he will be 0.1 in May . Oh BUT - "uPSA doubling time has no real clinical value predicting real progression". Well, I must admit I did read that in papers, so I could not say anything there *mehhhh.

And than : "maybe this will just plateau at 0.05 and stay there".
(In my head I think yeah, for some other lucky person it is a possibility).

So, we wait May uPSA and go from there, unless tomorrow's zoom with RT guy gives us different prospective but I do not think so.

My personal opinion is that as time passes they are all somehow readjusting and re-evaluating real need for aggressive, early or intensified treatments - I think that they are now seeing that more is not better , especially with emergent of new advanced medications and modalities. 🤷‍♀️

For example, for long time trend was of having 6 mos ADT with sRT , now there is a new idea developing that for low risk patients ADT might not be necessary at all and that 6 mos it enough for high risk . ( https://www.urotoday.com/video-lectures/asco-gu-2026/video/5413-poseidon-meta-analysis-re-examines-the-role-of-adt-with-salvage-radiation-for-prostate-cancer-amar-kishan.html)

At the end - EVERY day some new study shows something new and even opposite of what was considered "the best" just last year.

So - "keep on swimming, keep on swimming 🎼" (Dory song from "Finding Nemo" ) lol