It’s definitely better to wait to see if your PSA rises before doing anything. Since you are a Gleason seven, it could be a very long time before it comes back. You did have seminal vesicle invasion, which can be a problem, but they probably got rid of it all in surgery.

I know people with Gleason nine that went decades after surgery.

Yes, you could get adjunct radiation instead of waiting for salvage radiation but with a 4+3 it doesn’t make sense. I was a 4+3 and I’m still around after 16 years even though I have BRCA2. The treatments today work.

Here are some info on adjunct radiation in case you’re interested in what a well respected doctor has to say about it. You do have two of the risk factors, but other people in this forum have looked at this, considered this and decided to wait.

Adjunct radiation
Dr. Efstathiou concluded as follows:b
* Early salvage radiotherapy is favored over adjuvant radiotherapy in most patients
* Consider adjuvant radiotherapy in otherwise fit, motivated, very high-risk patients with ≥2 of the following risk factors:
* pT3b-4
* Gleason score 8-10
* pN+ Lymph node Metz
* Decipher score >0.6
* In high-risk patients, use lower thresholds to initiate ‘ultra-early salvage or adjuvant-plus’ radiotherapy
* If giving adjuvant radiotherapy, it implies high-risk disease. Thus, Dr. Efstathiou would recommend treating the prostate bed and pelvic lymph nodes, in addition to short-term versus long-term ADT, depending on risk factors
* May consider genomic classifiers or artificial intelligence tools to help with informed decision-making
* The goal is to avoid (or delay) radiotherapy in those who we can, without missing a window to cure patients who are guaranteed to recur

Here is a link to the article supplied by @surftohealth88 originally
https://www.urotoday.com/conference-highlights/apccc-2024/151546-apccc-2024-debate-how-to-best-manage-a-fit-patient-with-high-risk-localised-and-locally-advanced-prostate-cancer-how-to-select-patients-for-adjuvant-therapy-after-radical-prostatectomy-and-how-to-treat-them.html