My first post op PSA - mixed feelings - is 0.03 good enough with single positive margin?

Well said, Octorobo,

At the end of the day, we each have to make, and live, with our own medical decisions. And despite the efforts at DD, we don't always get the results we thought or calculated. As the common expressions goes, "It" happens. Even the best doctors get it wrong. Patients make mistakes in their choices. Part of the fun game we call life.

Study hard, choose wisely, hope for the best. A secondary PC treatment has so many implications and potential ramifications, it pays to really think it through, and sit back a short season, and see if you still feel you should move ahead at whatever juncture you find yourself at.

Mos_Ser,

I interviewed two RO's before treatment. I suggest you do the same. I don't think that there are any guidelines that say start RT asap with your pathology. So I'm a bit suspicious why he is pressuring you. Your numbers just aren't that bad. You have a favorable intermediate grade cancer that is slow to develop. The one positive margin is the only adverse factor that I see (other than having Pca). But it's a grade 3. You may never need further treatment. A psa score of .03 only 7 weeks after RP isn't indicative or definitive of anything. Have a new test in 6-7 weeks, or a total of 3 months post RP. That might clear the mud a bit. Even so, the most important thing for you to do now is heal! If it shows that the psa continues to rise, I would consult with your uro or maybe a MO about a short term ADT treatment will give you more time to heal before RT. Your Pca is NOT aggressive. You can wait. If you jump on it too soon unnecessarily, you risk not being able to fully heal. The RT treatments are a breeze. I've had no complications whatsoever. But I had 19 months to heal after RP. Good luck. And start working willy as soon and often as possible.

JFL, thanks for your input!
I checked the gudilines, RO is right, see below
Guideline Statement 2. Patients with adverse pathologic findings including seminal vesicle invasion, positive surgical margins, and extraprostatic extension should be informed that adjuvant radiotherapy, compared to radical prostatectomy only, reduces the risk of biochemical (PSA) recurrence, local recurrence, and clinical progression of cancer. They should also be informed that the impact of adjuvant radiotherapy on subsequent metastases and overall survival is less clear; one of two randomized controlled trials that addressed these outcomes indicated a benefit but the other trial did not demonstrate a benefit. However, the other trial was not powered

Anyways, guidelines are guidelines, not an exact road map: they show directions, not exact route.
I will wait and see