Bad 1yr. PSA retest.

I'd guess a bit of both.   As you see in my signature, I had a rising PSA after surgery,  It bounced around between .09 and .04 a couple of times, then shot up to .24.  Very nerve racking!

From what I gathered at the time, PSA readings can jump around and still never go too far up.  So you could be skipping around a bit and never have it go up too much higher.   In my case, I decided that .2 was my line in the sand to seek additional treatment.

In your case, the great thing is your initial post surg numbers were great.   THat's pretty significant.  At .11, I don't know if I would have pulled the trigger on additional treatment, but you might ask your URO for a referral to a good Radiolgist/Oncologist just to have a consultation.   For me, salvage radiation was the next step (along with HT)....and I've been clean ever since (knock on wood!)

Here was an instance where you wanted a positive margin, because its suggestive of residual disease in the prostate bed.  It makes sense that there might be a little cancer left behind, and that you can zap it with radiation....and I liked the ide of enhancing it with hormone therapy.  Localized cancer like that is still quite curable.  And while radiation isn't tons of fun, most guys on this board who've had it will tell you its not really that bad.   Same for HT, although the side effects are kind of sucky, very manageable.   I was only on it for six months, although I felt the effects for a year.

Hope you don't have to go this route, but in case you do, I was also concerned with going backwards on continence and ED.  Not really the case.   I cleared up on continence pretty well after my RP, but the radiation did set that back a little.  I'm good now -- maybe just a little leaky here and there, but nothing I need pads for.  ED was another issue, but I had non-nerve sparing surgery, so I wasn't really all that hopeful on a recovery there.  But once I hit about the one-year mark AFTER radiation (when the HT wore off)... I was surprised to find usable function with the aid of Cialis.

Hope this helps.   Good luck and keep us all updated. 

Bootheel

I had similar numbers as you, except my PSA was .08 at  6 months.  My surgeon and oncologist recommended RT with hormones, and I agreed.  However, as my surgeon said, the radiation would probably destroy any of the nerves he spared.  I have one hormone treatment left, and have been pulling solid "0's".  I have worked hard not to let the hormones effect my life, and am looking forward to getting rid of them.  My first desire in all of this battle, is to win it by increasing my chances for a long life.  If you could have the option - 5 years with a functional sex system, or possibly more than 10 without.....  Decisions we have to make with this beast.

Hey Boot,

I am pretty much in the boat with Mugaboo.  I completed my salvage radiation one year ago and have had no E.D. problems but i have experienced some incontince urges in the past couple of weeks and had to start doing kiegl exercises again which seem to have helped resolve the issue.  My PSA went below .01 at the six month point after radiation and my radiologist put me on a once a year schedule for PSA testing which I was fired up about but which some folks don't think is a good idea.  He seemed confident and after all I have been through I loved that so I think I am gonna go with his recommendation and see how it goes. 

The thing that you need to consider most in my opinion is that it has definetly be proven that the lower the PSA burden when you start radiation the better result you are going to get.  It is such a crap shoot as we all know and with your gleason the beast may never get you but you are young and therefore that complicates the decision.

Like Mugaboo I think I made the right call but I don't think the impact of the radiation is complete yet but on the good side of that its impact on the cancer hopefully isn't finished yet either.  From most of what I have read radiations impact goes out about two years and that is where most people see their psa nadir and the full impact of side affects.

Good luck