salvage radiation after surgery?

[Granolaberry]

Hi - Shouldn’t I be doing salvage radiation or chemotherapy now? I had my surgery February 25 and Doctor wants to wait for first PSA iat end of May. However surgical pathology showed negative margins but showed intraductal, cribriform, loss of PTEN. and PNI. Even though there was no EPE, no SVI, No LVI and no cancer in 10 removed lymph nodes- shouldn’t we be hitting this hard with radiation/chemo? 4-6 weeks after surgery? The other adverse features show aggressive behavior. Should I get a second opinion?

[Granolaberry]

sorry I meant to say - don’t I need adjuvant treatment? New to all of this and I don’t have a medical background

[Justfor_ in reply to Granolaberry]

Definitely NO. First off you should allow 6 months at a minimum for your tissues to heal. Secondly you shouldn't wait until the end of May for your first PSA test, you should have done it already 5-6 weeks post RP. Don't try to guess on slim information, learn where you are NOW.

[Granolaberry in reply to Justfor_]

Surgeon said three months

[Justfor_ in reply to Granolaberry]

Surgeon is plainly silly or lazy trying to avoid an "early" attention to your case.

[FMOH_N]

you should get a PSA at 6 weeks. Maybe MSKCC or other center of Excellence can provide a second opinion.

[Jp2sea]

It's standard to wait for a test to understand where you after treatment, and if going to do salvage, I think typically you would start lupron after that result, and after a few months salvage radiation may begin. Mine started about 6.5 months after my RP. Lupron typically continues for 2 years.

[Murk]

Agreed with most above, in the mean time research and find a well respected, highly experienced RO in your area and start having discussions. They will want to meet, review all your records and then provide their opinion and a going forward plan.

This research and then meeting etc will most likely will take time equal to your healing needs and timing for a PSA which they will prescribe.

I love second opinions so find even another great Doc / facility and even travel if needed. You will gain great insight and a plan with the next three steps will become obvious. This will bring great comfort.

Leave the Urologist behind...