1st PSA test seven weeks after surgery

I am not a MD, but my hunch is that they will probably start you on ADT straight away to do radiation three months down the road. Did you have a PSMA and Decipher test already? If not, it may be good to get these.

From the discussions I have seen here on the forum you should insist on Orgovyx instead of Lupron. Also, they might want to add an AR antagonist, it seems it is also important to choose the right and a latest generation one. Other people here should be able to give you more advice on that.

Yes I meet with MO for the first time on July 16 (next Wednesday). I already met with RO and I believe I will start radiation late August or early September once I am done healing from surgery. I had already expected multiple ADT meds but now wondering if they will add docetaxel as well?? Thanks!

I think @jeffmarc will soon chime in on this. He is the petson who would know.

My understanding is that they usually do 3 months of ADT to weaken the cancer before radiation.

Best of luck!!!

Thanks @topf , That is my understanding as well. This also my expectation that I will be on ADT medications for 3 years. I also sugggested to my doctor that I should do docetaxel but not sure she will go for that yet. I feel like another PSMA PET scan should also be done.
Thanks!!

John, I'm sorry that it's an ongoing thing for you and I hope the ADT + radiation destroys this cancer!

Thanks @survivor5280 !!
I’m up for the fight, but this is a serious punch to the gut. I knew my PSA would not be undetectable, but thought I would come in around .2-.5

How many days between the prostatectomy and the PSA test? I had one at seven weeks after my prostatectomy and I was undetectable < .1. Over 14 before.

I think moving forward with the radiation is a really good idea. You have live cancer cells hanging around the area around your missing prostate location . The longer they hang around the more of the chance of them getting into the bloodstream and of spreading around where they’re at.

ADT is a really good idea. You don’t tell us your Gleason score and that is really critical to tell you what the guidelines are not what our opinion is. Getting on ADT will stop your cancer from growing and spreading and usually shrinks it. How long you stay on it is based on many things.

It seems your doctors are doing what is considered the standard of care. It’s nice to see they’re trying to really obliterate that cancer.

Your cancer is very treatable. Long-term the Outlook is good with all of the available treatments we have today.

I had surgery 15 years ago and 3 1/2 years later it came back. I had salvage radiation and 2 1/2 years later it came back. I went on Lupron and it’s come back a couple more times, But I’m still around. I have a genetic problem BRCA2, Which prevents my body from correcting genetic errors leading to prostate cancer. 20 months undetectable!! The drugs work.

Hey Jeff, I am Gleason 9 (4+5) which is why I want to be more aggressive than standard of care. I talk to oncologist this Wednesday. I have my radiation simulation on Aug 20. This psa tested was exactly 7 weeks post surgery (49 days), but I had positive margins, PNI, EPE, SVI and LVI.

I can’t blame you for not wanting to wait. If you really want to jump on it, ADT plus abiraterone Is where they would go if you had Metastasis.

The thing is, If you go on ADT, your PSA will drop to nothing and if he does, you don’t really need a second drug. Something to discuss with your doctor, I think you’re right on the border of needing that second drug and I’m no doctor.

There are, however, some things going on that might interest you. If you want to stay castrate sensitive for the longest time than apalutamide might be an answer, There’s a study going on right now.

Thanks Jeff! What about Orgovyx + Darulamitide and then after radiation docetaxel to get anything in my bloodstream?