Post RP Treatment Recommendations

Recommendations:
Once thing at a time, at 3 weeks you have a lot of healing to do yet. Slowly but surely become as active as you were prior to the RP. Do your kegels, lots of kegels LOL. Try to get your quality of life back as best as you can.

PSA has a 3 day half life I believe, don't expect too much on that first blood test, what's important is that it's going in the right direction. If it's undetectable or not depends on how high the PSA was when you had the surgery.

"..the tumor was contained within the prostate and both lymph nodes and seminal vesicles are free of cancer.."
All excellent news, take the win here.

Unfortunately the invasions aren't good news, but, they don't have to be bad news either, all depends. If the Pca cells found in the margins and Perineural tissue are all there was, the surgeon may have gotten it. If it got past that point you may need some follow up. Monitoring the PSA will give you the indicators that you need.

Didn't the doc(s) have this report when you had your cath removed? What did they have to say about it?

I realize what you're dealing with, been exactly there. My best medicine at this point was work on my recovery from the surgery and enjoy myself getting back to normal activities as best as I can.

During the first few weeks after my RP, I started going down internet rabbit holes, " researching" what-ifs in regards to the positive seminal vesicles and margins on my path report. I realised this was not doing my mental health and emotional stability any good. That the only thing which mattered was the post-op PSA, and we didn't know it yet. My surgeon endorsed that attitude, saying I was not (yet) a candidate for further treatment.

After the 6 & 12 weeks PSA checks, the next steps will become clear. Here's hoping both of yours are "undetectable".

Thank you - very helpful. The doc(s) did not have the pathology report at the time the catheter was removed, but we subsequently talked on the phone and they want to wait until after follow-up PSA tests are completed for any next steps. Until then, I am taking your advice.

Thank you. Helpful advice. I hope that you stay well.

I'll second @trusam1 's comment about chasing what-if's.

I didn't have a RP because by the time it was diagnosed my cancer had already "escaped" into my spine, but I did have spinal surgery and radiation to both the prostate and the secondary tumour.

For the first year afterwards every little ache or pain anywhere in my body made me worry there was a new tumour. My family doctor told me it's a normal reaction now, but she'll be concerned if I'm still doing that in 5 years.

This is traumatic stuff, both getting a cancer diagnosis and having life-altering surgery. You'll need to give yourself time, maybe months, maybe years to get used to it. You can never have a 100% guarantee that the cancer is gone, but I promise you that the worrying will get quieter over time, and the other parts of your life that you enjoy will get louder again.

Thank you for the wise words. I look forward to the "worrying getting quieter over time."

I can only tell of my experience. I had a radical prostatectomy in 2008 and like you everything seemed to be good. I did the same follow ups on a regular basis for at least a year with a PSA of 0.01. All of a sudden, 11 years later my cancer came back in the prostate bed. A bit shocked. So, that being said I'm not sure that there's anything that can be 100% certain when dealing with this.

Thank you for sharing your experience. Understood. I hope that your subsequent treatment was successful. What was the subsequent treatment?

Thanks for sharing your history. Good point: there isn’t anything for certain about cancer. How often have you been getting your PSA tested? I’m two years into my recovery. Up until now, I’ve been tested every three months. (Cancer was detected in one lymph node following my RP.) Since then, my cancer has remained in remission, Therefore, I’ll now get my PSA checked every six months for the next three years. Who knows, maybe even longer. Hope your doing well.

I was having it tested about every 6 months and in the 10th year it started rising. In the 11th year a MRI showed cancer in the prostate bed. I had 6 month hormone shot and 36 radiation treatments. That was 3 years ago. My PSA is now continuing to rise again after the first 6 months following my radiation. I have had 3 PET/MRI scans since and none have pinpointed any cancer. So, my urologist, oncologist and mainly myself, decided to wait. I don't want to treat numbers. I would rather find where the cancer is and go from there as to what kind of treatment to have. I'm tested every 3 months and my PSA is now 02.43. I don't worry about it. I don't hurt, I have no obvious symptoms and no issues that is evident. It is what it is. Worry will not cure it. I'm 79 and in good active health otherwise.