slowly rising PSA after Surgery and salvage Radiation

Holiday greetings to all my fellow pc patients.

So far i have had surgery, and when my psa continued to rise(immediately) i had salvage radiation. My PSA has now gone up 3 consecutive times since salvage radiation.

Currently both my Radiation Oncologist and Urologist are recommending i hold off on meeting with a medical oncologist and say that they will test me to death and i can wait until my PSA hits 20. I feel well and have been working out in the gym and eating healthy. They seem to feel that i should wait to take hormones as i have good quality of life and should delay the side affects of hormone therapy.


PSA before surgery was 12.x
da Vinci surgery 4/4/2013
First PSA after surgery 5/14/2013 0.34
Second PSA 7/5/2013 0.52
Salvage Radiation (IMRT/IGRT) – ended September 29th 2013
First PSA after salvage (SFran) 12/9/2013 0.60
Second PSA after salvage (SFran) 3/5/2014 0.60
Third PSA after salvage (Sfran lab 6/12/2014 0.70
Fourth P.S.A after salvage (sfran lab) 9/12/2014 1.20
Fifth PSA after salvage (sfran lab) 12/12/2014 1.80 – cancer re-occurance


My Patholgoy report from Surgery:
Pathology:
Radical prostatectomy 4/4/2013:
Specimen Source:
Prostate
Right Pelvic lymph node
Left Pelvic Lymph Node
Diagnosis:
Radical prostatectomy specimen (46 g)
Extensively involved bilaterally with prostatic adenocarcinoma (Gleason pattern 4+3, total score 7)
Approximately 45% of prostate slides contain tumor
The greatest diameter of tumor is 1.8cm in the left posterior inferior aspect of the gland
The tumor extends into, but not beyond the prostatic pseudocapsule but is focally present at a right posterior mid pseudocapsular recestion margin
Intraprostatic perineural infiltration with tumor and high grade PIN are identified
The apical, base, pseudocapsular and soft resection margins and seminal are negative for tumor
One Lymph node negative for tumor
One Lymph node negative for tumor
AJCC stage: PT2NOMAX

Prostate Gland:
Histologic Type: Adenocarcinoma (conventional, not otherwise specified)
Histologic Grade Primary {Pattern Grade: 4
Secondary Pattern Grade; 3
Total Gleason score: 7
Primary Tumor(pt): PT2: Organ confined
Portion of lobe involved PT2c: Bilateral disease
Regional Lymph Nodes: pNO: No regional lymph node metastasis
Number of nodes examined. 2
Number of nodes involved: 0
Distant Metastasis(pM): pMX: Distant metastasis cannot be assessed
Seminal Vesicle invasion: Seminal Vesicle Invasion absent

Find a good Oncologist who treats many PC cases and get his opinion. Urologists are operating outside their job description once metastasis starts...I was on adjunct hormone therapy as part of my salvage radiation treatment. When that failed, I went back on Lupron then added Casodex and endured the results of that. But my cancer is still in remission and overall, my QL is good....

Add to the possible scans to locate the cancer the nano-MRI (formerly Combidex) in Nijmegen, Netherlands, does not rely on glucose sensitivity and sees down to 2 mm or so.