Getting varied recommendations on treatment after surgery: Confused

Posted by fabianrinaldi @fabianrinaldi, Apr 2 7:53am

Hello, my name is Fabian.

I had a radical prostatectomy on October 24. My pathology showed Gleason 7 (4+3) with a cribriform pattern. The surgical margins were negative and the lymph nodes were clear at that time.

Three months after surgery, my first PSA was 0.21, and one month later it increased to 0.25. This has been very stressful for me, as I was hoping for an undetectable PSA after surgery.

Now I’ve been told there may be involvement of a left iliac lymph node. My doctors are recommending radiation therapy, but they don’t fully agree on whether I should also have hormone therapy (ADT). My urologist thinks it may not be necessary, while my oncologist believes I should add it.

I feel a bit confused and anxious about making the right decision.

Has anyone here gone through something similar? What treatment did you choose, and how did it work out for you?

I would really appreciate hearing your experiences.

Thank you very much.

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thomasmichael | @thomasmichael | Apr 4 9:22pm

I also had the same surgery 7 years ago. Gleason 9. My PSA started going up a Cpl years ago. Oncologist recommended hormones. That’s what he is trained to do. My radiation oncologist recommended radiation. That is what he is trained to do. I have stuck with the radiation. Less invasive. Fewer side effects. If it doesn’t work anymore I go to hormones. It’s been a wise decision. At least for me and my symptoms.

Colleen Young, Connect Director | @colleenyoung | Apr 15 9:08pm

In reply to @imo "same situation had surgery PSA increased started radiation and orgovgy PSA now .1" + (show)

@imo, welcome. How are treatments going? How are you doing?

wheel1 | @wheel1 | Apr 15 9:27pm

Not that this is the case, but in posting comments that you know many are going to read, you want to allow others to hear of possible new break throughs that are taking place. At UCLA after a radical prostatectomy, if BCR occurs and a PSMA Pet shows it appears in a certain lymph node, instead of immediately running off to radiation and ADT, they now can go in for surgery to remove the specific cancerous node. While they have you open on the table with dye they can actually pin point the specific node and remove it. This is why it is so important to keep up on the research and latest technology and techniques such as the single port robotic and having your margins sent to pathology for checking while you are in surgery to keep from getting a pathology report that says positive although everyone kept saying the Pet scan says it is contained. Many patients take the surgeon or radiation oncologist that their urologist refers them too without first at least be aware of cutting edge technology