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Post RP PSA .3; twelve weeks post RP, PSA .8
Had RP late January 2026, removed lymph nodes as well; pathology showed lymph nodes negative. Three weeks post RP; PSA at .3, 4 weeks later, PSA at .56; 12 weeks PSA .82.
Pathology Gleason was 9 with all of prostate cancerous.
Pre Op PET/MRI/Bone scans all showed no metastsis. I don’t like the sound of ADT/Radiation side affects; what if I don’t treat?
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Recent studies have shown that people who have aggressive cases like you have and don’t get salvage radiation by .25 have a lower chance of progression free survival.
Then you have doctors like Kwon and Scholz Who feel that people should wait until the PSMA PET scan shows something and then zap it. While they discuss that at the PCRI conferences, I’m not so sure it really works as well for people that have aggressive cases like you have.
It’s pretty clear that surgery was not the answer for your Getting long-term remission.
I had surgery and then 3 1/2 years later my PSA started rising so I had a six month ADT shot and 40 Sessions of IMRT. I had the sessions early in the morning and would go to work all day every day, had no issues at all. Nowadays, they do it in fewer sessions and people usually have some urinary issues others have proctitis. And some people have no Real problems. When I had that ADT shot? I didn’t even notice it, But it was only six months and you were probably going to get one for 24 months because that is the standard of Care for your aggressive cancer.
You really have to consider the fact that yours is very aggressive. It came back quickly and it came back with a fast PSA rise.
Rick Davis talked about this type of decision in the recent ancan.org Weekly advanced prostate cancer meeting. Rick, who started ancan.org, talked about his friend who had a Gleason nine and decided that after a year of ADT he would stop because it Interfered with his running a big company. He encouraged the guy not to do it, But he did it anyway. Within a few years, he had to have chemo, it had spread considerably. He died not long after. Just something to think about. Weigh how aggressive your case is, what aggressive things were found.
Just some things to think about. Long-term survival with prostate cancer requires regular treatments that are parts of the standard of care. Sure, some people can get around them and still survive for a long time. Can you?