Post prostatectomy. 1st PSA at .30, 2nd PSA at .43, future prognosis?

Good morning,

Pertaining to my rising PSA after prostatectomy. (7-2-25)

My decipher score is .6, and the information along with it recommends radiation first.

Question, after a prostatectomy what is the recommended healing time prior to administering radiation?

Thanks.

Mike

I meet with my Oncologist on 10-2-25.

Hey Mike. I had pretty much the same as you. My doctor put off radiation as long as he could due to incontinence. It can have an impact later. A year later I started Eligard, then radiation 2 weeks later. Best of luck to ya!!!! 👍

Doctors usually wait 3 to 4 months after a prostatectomy to do radiation. They do it based on PSA so if your PSA has not stayed undetectable, then radiation will give you longer progression free survival.

They don’t base radiation on your decipher score, If your PSA is rising, then the decipher score is a factor.

Thank you again for the prompt response!

My Decipher Score Information states the following:

Clinical studies demonstrate that Decipher intermediate-risk patients with rising or persistently elevated PSA after radical prostatectomy have moderately aggressive tumor biology.

These patients may benefit from earlier post-prostatectomy radiation.
- They were less likely to require salvage hormone therapy when treated with earlier radiation.
- Decipher intermediate- risk patients with rising or persistently elevated PSA may receive oncologic benefit from postoperative radiation with concurrent hormone therapy.

Always appreciate additional insight! This will be discussed at my upcoming Oncologist appointment.

Thanks!

Mike

Hi Mike,
Hope you got good advice because that’s the treatment I am in now. Prostate surgically removed in October. Cancer in the margins but nothing detected outside of the prostate area. Did 8 weeks of radiation and doing adt for next year and a half, as far as I can tell.
Hot flashes, man boobs (minor) and I cry too easily lol. Radiation was a piece of cake, for me anyway.
Had my first test a month or so ago. .03. We shall see what happens on the next one.
Gleason 9, age 57.
Best of luck to you brother. Hang in there!

Well, as I said originally, your PSA never did hit undetectable after surgery. That along with a decipher .6 test, definitely says you have to do radiation soon.

You are going in the right direction. Hopefully this will give you remission for a significant amount of time.

When threads get long it is hard to remember exactly what people said previously, Hopefully, I didn’t mislead you at any point after my first comment about your doctor being right on target.

Hi Ej : ), would you mind sharing what was you post op PSA level ? How long after RP you started your therapy ?

Thanks so much in advance : ).

Thanks so much for sharing your very interesting case and unusual treatment - it is fascinating , to say the least !!! 😃😎

Can you share details about your diet - it would be very much appreciated.

Wishing you forever remission and many, many more years in good health 🍀

All,

ej 4902, the hormone (ADT) does concern me! Hot flashes, good to hear the man boobs were minor for you and I am an emotional person as well! The diet question asked of you would be interesting to read. Thank you for sharing!

Jeff, as always your advise is greatly appreciated! I am learning and asking questions as we address my future treatment procedures. I am understanding from what I read that I may have options as how to proceed. We will have the conversation with our Oncologist in a couple of weeks. I understand these threads are easy to mix up. Thank you again!

The best of health to all of us! Thank you all for sharing and being part of this discussion!

Mike