You haven't given us enough information (nor does your bio) to even begin to think about this. You stated "Recent PSMA scan negative no recurrent disease ." and then asked about radiation. Exactly what are they going to radiate?
It's been 10 years - and you're still below 2.0PSA.. (0.4?) - I again have to ask - what are they going to radiate?
If your original treatment was a RP - then the 0.4 might be some cause for concern - which at this point would probably be watching and waiting to see if it continues up, or if it was just a blip. Personally I certainly wouldn't make any sort of decision based on 1 PSA reading (and not a particularly high one even if you did RP, and insignificant if your treatment was originally radiation.) And I'd certainly want another PSA test (even if out of pocket - it's not expensive) along with a T test before even thinking about doing anything.
Photon vs Proton - no particular advantage to photon except the selling points the treatment centers like to trot out when you drop by (BTDT). Have you had any radiologist not associated with a proton center advise getting proton?
I think you're perhaps over-reacting to a number on a chart.
Thanks for your feedback I do appreciate it and really apologize if I did not give you enough info.
I asked the same question to the oncologist. He indicated the prostate bed would be radiated. I had surgery in 2003 and the PSA was zero until 2013 in which it bounced going no higher than .03. Then two recent consecutive tests 0.48 then dropped to 0.42. My urologist indicated the watch and wait approach but suggested if I wanted to see a Radiologist which I did. Again, sorry all for not giving you all the info.
If it were me, I would just watch it. But you're not me, so you have to do what's right for you. My thinking is that if a bit of pattern 3 got left in the prostate bed, pattern 3 progresses very slowly, if ever (it can grow and form a tumor, but it seldom changes grade), and most (but not all) men on active surveillance with pattern 3 only, have stayed on it without grade progression for 20 years so far.
With watching, there are no side effects of radiation, but there is the anxiety of knowing something is still there.
Each guy's body reacts differently to the same treatment(s). For me, Lupron was a lot worse than either of my two radiation treatments. Lupron turned me into a couch potato even though I've always exercised regularly to keep in good shape, whereas with radiation alone I could do cardio exercise regularly for 90-120 minutes at a time. Radiation weakened my anal sphincter/rectum slightly but it doesn't require anything other than hitting the restroom a little sooner than I used to when the urge hits.
My first radiation was post-RP salvage radiation done without any ADT and it gave me 7.5 years of undetectable PSA.
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