Well, I thought I'd add a little bit here since there are some similarities between my case and Aachen's.
Going into surgery (at age 49), my PSA was 4.5 and a gleason score of 7. After surgery, that gleason was downgraded to gleason 6 but my pathology also showed a focal extraprostatic extension (EPE) with a positive margin of the posterior surface of the right lobe. There was no evidence of lymphatic or seminal vesicle involvement. Even with the EPE and postive margin, the pathologist staged me at pT2cpN0. (It's my understanding that a EPE / positive margin should be staged at pT3x.)
My first post-op PSA taken at six weeks showed <.01, or undetectable. Unfortunately, 3 months later, my PSA measured at .01. Since that time (almost two years now since surgery), I've been checking my PSA every three months and have been watching a steady increase in my PSA (see signature below). In fact, I am currently waiting for my latest test results to show up in the mail.
Can gleason 6 PCa survive outside of the prostate? My case particulars would suggest that it can, though it should be stated that there is a big difference between a local PCA recurrence in the soft tissue of the prostate bed and metastasis to distant sites such as other organs or bones.
So with my supposed gleason score of 6 after surgery and an ever-increasing PSA, I have to assume that either I was incorrectly staged by two pathologists after surgery or benign prostate tissue was left behind, which my urologist says didn't happen.
I am scheduled to consult with a radiation oncologist this very afternoon and am eager to hear how he would approach my particular case.