What's your radiation therapy experience as a pT3b cancer patient?

@jeffmarc
My Gleason at biopsy, as well as post-op, was 3+4=7 with only 6-10% of cells being "4". I am now 7-months post-op. I have had two PSA levels at three and six months post-op, and both were < 0.1 ng/ml. I have my consult with a radiation oncologist in early December. The assistant/nurse scheduling me seemed confused as to why I was being referred to their practice "yet" or "at all". That further confirmed in my mind what you offered with the quotations of that well-regarded physician who established criteria, saying that you needed to have two or more criteria to be considered a candidate for radiation. I do not have two or more such criteria. It is just that I am a pT3b. My urologist was kind of "on the fence". He was feeling me out about how "I felt" about radiation, because he is concerned with the 25-50% probability of my cancer returning "within" 5 years post-op. He said it is just the "nature of being a pT3b...it always comes back." I asked: "well what is it...25-50% chance or 100% chance?" He said that he has not had a pT3b that didn't eventually recur. (so basically 100% probability of recurrence). But then...
This whole blog is full of guys with all kinds of prostate cancer categories, Gleason Scores, Decipher Test scores, etc., and all of the pathology that goes with it (EPE, Perineural invasion, surgical margins, Cribriform glands, seminal vesicle invasion, etc.), and we're all here because our cancer came back "at some point." The more I ponder it, the more I am convinced that no matter what type of prostate cancer you have, and even though the surgeon removed the vasculature that supplied the tumor cells (so they "should" die), it always seems to come back. The only thing that gives us 10 or more years of longevity post-prostatectomy is that the cancer grows slowly...even the ones termed "more aggressive." It's a crap shoot. I am a guy with a scientific education and background, having been the Director of Clinical and Anatomical Pathology in a few hospitals, before jumping to the manufacturing/sales side of the industry. I am used to the math...the science...the logic...and work effort that says "if you do this, then you can expect that." That does not apply to prostate cancer. As the famous line from the movie "A Passage To India" saw the Guru character say: "You can do what you want, but the outcome will be the same." That is a mystical, fatalistic version of "what will be will be" so don't drive yourself crazy trying to change things, because it is going to do what it is going to do...regardless. And that pisses me off. I..."we" have no control over this. That is why physicians say they "practice" medicine, because nothing has been perfected yet. They just do what their education and experience suggest they should do, and they hope for the best.

@jeffmarc I haven't had any treatments. I've had a series of PSA tests, an MRI, a biopsy, and PET scan. The PET scan report stated there was no evidence cancer had metastasized, but it also stated there was no uptake in the prostate. The RO has ordered a pathologist for a second look at the biopsy, and he will order a Decipher. He describes my situation in his clinical note as "at least high risk" which implies to me he has observed something he wants to find out more about with his order that the biopsy be reevaluated. As things stand right now, he has a plan to put me on some sort of ADT for 6 months. One month into ADT he's going to start RT - 20 treatments spread over 4 weeks. He's conducting a randomized clinical trial I may sign up for where one arm is 5 treatments and the other arm is 20 treatments. He claims to have already concluded based on a previous study he did that the outcomes are equivalent. He says he's repeating the trial because he didn't convincingly randomize the patient selection last time.

I don't conclude its game over for me. I just see more uncertainty than the assumption I was living with, i.e. that since my mother and father did not get cancers and lived doing well into their late 80s that I might fare as well myself.