PSM. SRT??

I returned to my urologist today for the first time since my surgery. (My surgeon was another doctor). He told me that radiation was their standard protocol for positive margins. I wasn't suprised by this, as from my studies I've read where there's differing philosophies on whether to zap now or wait for a rise in PSA. (Although, I must admit, I was hoping he'd be in the "wait and see" camp).

From the stuff I've read (and it's all different, so this is a distillation) there's somewhere around a 40 to 70% chance of recurrence (depending on the study). My doctor said he believes that to be high...closer to a 1 in 4 chance. He said if it were him, he'd wait for a rise. But...its not what he recommends.

I see where more and more men are beginning to wait until there's a rise in PSA before they "re-treat"(about 70% wait).

So...The way I see it, its 50/50 I'm cured now (or 75/25 according to him). My thinking right now is to wait. He said we'd talk about it next time I come in as there's no hurry. He likes to wait at least 6 mos for healing anyhow. What I've got going for me now is that the margin is all G6. I'm also fully continent and no ED.

The problem with waiting until there is a rise is that the chance of a cure supposedly diminishes.

I told him I needed to do more research to see if it would pay to just skip the radiation even if my PSA begins to rise. (That didn't go very far). .

I've not talked to JH. Who would you talk to up there? A surgeon, rad. onc, or just an oncologist?

What I really need are some figures on how long before clinical indications of cancer begin to show up if one does forgo SRT completely. I haven't seen much on that topic yet.

With multiple margins and high volume involvement, my uro referred me to a RO at .022. I interviewed two RO's and they both advised radiation. One said sooner than later. One said I could wait, but it was inevitable. So I went ahead at 19 months out. You've got time. Low involvement, one margin. If there is anything remaining, it's likely lingering in the bed. And it might level off or die off on its own. Still too early for you to do anything yet in my opinion.