PSA 6 weeks post surgery

Hey Jeff - Looks like you are doing ok on the PSA front. Keep in mind that small PSA values must be kept in perspective as the hundredths (0.0x) can vary a little so the extended trend is what defines a problem not any one or two results.

I differ a bit from Djin's G8 comparison in that my 4+3 tertiary 5 became a 4+5 in second opinion. It is a judgement call by the pathologist on a small percentage of grade 5 cells. However, the change seems huge as you go from G7 -> G9 due to this. My RO said that he treats to the highest number so the two pathologies were effectively the same to him and secondary treatment would be probable in either case. However, it was up to me to do it now or later if required. Urologist said the same thing.

The hard part is decide whether to pull the pin and go with adjuvant radiation within the 6 months after surgery or monitor the small PSA values and make a move based on reaching some small number. My review of the information available to me at the time indicated that adjuvant radiation provided the best long term results for people with adverse results (which is us). I thought hard about waiting and monitoring small numbers but that is a stress producer by itself and I said I might as well get it over with and move on knowing I did what I could. No regrets so far but everyone is different. Some want to fire all the guns, others want to study and justify everything they do incrementally. One of the approaches will make sense to you at some point.

Greetings Jeff,

From now forward the key will be to see where the PSA level goes from here. At 3 months I was at .022 with subsequent increased every three months leading to radiation and ADT (also had 4+3 with tertiary 5). I have seen folks where things stabilize and even drop. Your pathology and current reading suggest you will need to keep a close eye on things in order to make sure you can take action as/if needed. I am wishing you all the best and please keep us updated!