1st PSA after RP

[keepinon]

I am Gleason 9 with SV involvement and 2 positive lymph nodes out of 20. 6 week PSA is .9. Surgeon wants to do another test in 2 weeks. He thinks it may still come down a bit. He would like to see .5 to justify doing

SRT to pelvic bed. I am thinking an Auxim scan might be useful.

I was hoping to get some feedback from some of you very experienced and educated people out there.

Thanks ahead of time for your help/advice!

Bill

[Tall_Allen]

You should be talking to a radiation oncologist ASAP. Surgeons do not treat people who fail prostatectomy - they know next to nothing about it. Men who have persistent PSA and 3 positive nodes should have immediate adjuvant RT. Those 3 nodes may indicate that the cancer is still trapped in the pelvic area and that radiation there may still be curative. If your insurance will cover it, an Axumin PET scan may be able to rule out distant metastases.

[keepinon in reply to Tall_Allen]

My surgeon wants me to talk to RO, but my incontinence 6 weeks postop is an issue. How long can i delay RT?

[Tall_Allen in reply to keepinon]

You can get on ADT immediately. That will stop the cancer in its tracks while you heal from the surgery.

sciencedirect.com/science/a...

The ADT should improve the outcomes of the SRT.

[GoBucks]

Your PSA should be zero, not .9 or .5. Definitely see an RO soon. Have you had a scan to rule out bone metastasis?

[keepinon in reply to GoBucks]

Just normal CT and bone scans before surgery. Doing an Auxim scan now is a definite possibility.