Risng PSA post Da Vinci Surgery

Hi Forum Members - looking for advice please

Background:
Age 51.
In November 2010 I saw the GP and had a PSA test. Elevated PSA noted at that time 6.8. Saw a urologist who diagnosed prostatitis and proscribed antibiotics. Problem did not go away, and PSA slowly but surely climbed. Had a biopsy in August 2011, negative. Problems not resolved and PSA slowly climbed, until May 2013, when it reached 13, and I changed consultants. Biopsy performed July 2013, 6/9 cores positive, Gleason 3+4=7.
RP performed in London October 2013. T2B, 3cc of tumour in right node, negative margins.

Post op, have some ED, but doing better than I expected on Cialis. Good continence, however, at 6 weeks my PSA was 0.06, where the surgeon was expecting less than 0.04. At 9 weeks it was 0.08, and at 11 weeks 0.09. Am now scheduled for an appointment with an oncologist, specialism in radiation therapy. I also have an ache in my groin area, something that has been troubling me for 3 years (which is part of the original complaint that triggered the journey) and have detected a swelling on my right testicle. This I am told is probably epididymitis. This is being checked via ultrasound tomorrow.

So the questions to the forum are:
1) Given that the PSA readings are so low, should I really be rushing into Salvage Radiotherapy
2) Please share any experiences with Salvage/Adjunct Radiotherapy
3) Could the epididymitis be linked to the PC

Cheers

1) You certainly shouldn't rush but adding a few oncology specialists to your medical team now is sensible. They can help you monitor your tests and give you advice about what to do when. You might also talk to a "medical" oncologist -- someone who is a specialist in treating PC with drugs -- because the MO may do better at helping you time your response.

2) I had adjuvant RT after my RP, not because my PSA was rising (we didn't wait to see) but because I had a much higher than expected post-op Gleason score and I had positive surgical margins. My main struggle with the ART was continence issues. They like for you to have a full bladder when they zap you since it tends to move the target tissues away from other bits they are trying to avoid. The other problem with continence and ART is that the treatments tend to delay (or sometimes prevent) recovery of continence after surgery. Since you are doing well with continence you should be OK.

Aside from that the radiation therapy was not that big a deal -- kind of a long daily grind but none of the days stand out as horrible. And my PSA has been undetectable now for over a year. (But it remains to be seen what it does when my hormone therapy ends this summer.)

3) Seems unlikely to me. But your doctors are your doctors and I am just some random guy on the internet.

Alan:
I read what I assume is a synopsis of your pathology report from your post and I see "3cc of tumor in right node" and I assume this means a lymph node. Is this correct? If so, then this discussion is going in another direction.

Hi Tarhoosier

I meant to type right lobe i.e. contained in the prostate