Postop pathology to ChatGPT & asked about BCR. Anyone done this?

Posted by esperling @esperling, Dec 14, 2025

I used ChatGPT for the first time and input my post-op pathology details into it and then asked about recurrence. To my surprise, it stated that for men with “several high-aggressiveness factors” like mine,I.e.,
* Seminal vesicle invasion (pT3b)
* Multiple positive surgical margins
* Cribriform + Intraductal carcinoma
* Gleason 4+3
* Decipher score 0.89 (high-risk)
I should consider “ultra early” radiation therapy. It went on to state that a Sustained detectible PSA as low as 0.03-0.05 ng/mL should be used as a threshold to initiate conversations with your oncologists about radiation early salvage treatment and possibly, ADT. It specifically said,
“ PSA 0.03–0.05 ng/mL and rising (confirmed on two tests)”

And emphasized,
“Do NOT wait until PSA reaches 0.1. Patients with these features progress quickly once microscopic recurrence begins, and outcomes are best when salvage radiation is given at very low PSA levels.”

Referencing the AUA/ASTRO/SUO 2024 Guideline:
* Recommends early salvage radiation when PSA first becomes detectable.
* Strongly favors PSA ≤0.2, but many experts recommend ≤0.1 or even ≤0.05 for high-risk patients.
*
2. Multiple large studies
Consistently show:
* Best long-term cancer control happens when salvage RT is delivered with PSA ≤0.05
* Outcomes are significantly worse once PSA rises above 0.1
* Waiting until 0.2 (the “traditional” definition of recurrence) is now considered too late for high-risk patients.

It went on to explain that while the broad consensus guidance still defines biochemical recurrence at PSA >=0.2 ng/mL, the studies this was based on did not include a statistically relevant number of higher risk patients or account for their specific tendency for greater metastasis velocity.

It certainly puts new emphasis for me on watching my PSA very very closely and I will be discussing with my doctors on the coming weeks depending on the outcome of my next PSA (blood draw on Tuesday 12/16/25).

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

harvey44 | @harvey44 | Feb 9 8:32am

In reply to @wert1234 "@harvey44 With your friends case . What did they find out ? Lymph nodes and left..." + (show)

@wert1234 his case was the same as mine, left over tissue on his prostate bed. Mine was located where the urethra was stitched back. Both of us had radiation. He 44 episodes and in my case, 36.

surftohealth88 | @surftohealth88 | Feb 11 12:36pm

In reply to @wert1234 "What causes you to have a psa of 3.26 10 weeks first psa test after surgery?" + (show)

@wert1234
I hope that you are treated in Cancer Center of Excellence - please make sure to go to the best hospital in your area.
Cancer was left in your body and you need additional treatment ASAP.

Jeff gave you detailed advice and guidance and please proceed with finding the best treatment center in your area. I am surprised and concerned that your doctor is not the one that is answering to all those questions and is not on top of your situation already : (((.

wert1234 | @wert1234 | Feb 11 1:28pm

In reply to @surftohealth88 "@wert1234 I hope that you are treated in Cancer Center of Excellence - please make sure..." + (show)

@surftohealth88

Ya having a pet scan next week then seeing the oncologist the first of the week after . I had one done before the surgery’s / prostate/ lymph nodes. I am being treated at a good place. Just hard to imagine psa 3.26 10 weeks after surgery. It’s was over 13 psa before surgery. Wandering has this happened to anyone in the prostate cancer community? I was told they don’t radiate on anyone til at least 3 months out from surgery to make sure all is healed down there.

surftohealth88 | @surftohealth88 | Feb 11 9:25pm

In reply to @wert1234 "@surftohealth88 Ya having a pet scan next week then seeing the oncologist the first of the..." + (show)

@wert1234

Yes : (((, unfortunately it happens and we do have members who had positive PSA after surgery. They all had RT very soon after surgery and they were put on ADT before RT to stop cancer growth. They also had PSMA scan to check if cancer is visible and it should be hopefully visible with PSA of 3.26 .

I am glad to hear that you will have another PSMA scan very soon and hopefully you will have in depth discussion with RO and MO very soon too.

Wishing you the best of luck and full eradication of cancer in very near future.

wert1234 | @wert1234 | Feb 12 11:28am

In reply to @surftohealth88 "@wert1234 Yes : (((, unfortunately it happens and we do have members who had positive PSA..." + (show)

@surftohealth88

Thanks.

esperling | @esperling | Feb 12 2:08pm

UPDATE: My mid-December 2025 PSA was below the detection limit (ultrasensitive PSA test with result < 0.006 ng/mL). So I’ll continue to retest every 12 weeks for next 4 years and then every 6 months until I’m at least 10 years out. Let’s hope and pray it stays gone for the remainder of my life - but I’ll be prepared if it reawakens.

wert1234 | @wert1234 | Mar 4 6:17pm

In reply to @wert1234 "@surftohealth88 Ya having a pet scan next week then seeing the oncologist the first of the..." + (show)

@wert1234

Well got my pet scan back and I have 4 or 5 pelvic lymph nodes lighting up. No activity in the prostate bed. And my thyroid has showed up on 2 scans . So just had an ultrasound done on it. Met with the oncologist and starting ADT next week with Radiation starting in first of April. This the norm? Also , is anybody watching what they eat , seeing certain foods can progress cancer?

jeff Marchi | @jeffmarc | Mar 4 7:02pm

In reply to @wert1234 "@wert1234 Well got my pet scan back and I have 4 or 5 pelvic lymph nodes..." + (show)

@wert1234
What was the SUV for those lymph nodes?

Definitely watching what we eat. Red meat, whole milk deli meats, and high fat diets are big items to avoid because they can affect the cancers ability to grow and spread.