Almost 5 years

Hello-
This September will be 5 years since my dad had his radical prostatectomy. He has been doing well and having his PSA checked as he is supposed to. Here is a bit of info from 2012....In the biopsy they took 19 samples. 5 of them came back to be malignant. four of the five were rated a 7 on the gleason scale, with one being an 8. One side was clear except for a suspicious area so it seemed the cancer was on one side only. No lymph nodes or anything were affected, all scans came back normal. Anyway, 6 months ago his PSA came back as less than .13 and his last test, which he saw his doctor for this week, was .1. I'm a little nervous as I have read that .2 could mean recurrence. The doctor says it's fine now and for him to come back in 6 months but the paranoid side of me almost wants him to have it checked in 3 months. I think we al have that fear that it could come back and go to the bones....I'm guessing with them watching it so closely that they could get right on another treatment if they started to see things going sideways. Any input here?

He may have in the past, but I believe this was just a regular one. I have spoken to the doctor's office and they are not alarmed at this point. She said he can come in after 3 months, instead of waiting the usual 6, for peace of mind. I am a horrible worrier and I am praying all is well. She said just because it is .1 does not mean it is going to go up. She said if it goes up any at all the next testing they will evaluate in depth. Just praying all is well. My dad is 70 and like I said had been good now for almost 5 years since prostate removal.

Go with the doctor...you admitted to paranoia...why let it rule your decision......lord knows this forum promotes it ...so I understand the why of the "lie"....you do NOT need to do any thing quickly...listen to your doctor...whats your dad want to do?

Here's a nomogram with which he can calculate his probability of remaining recurrence-free over time (note: not just biochemical recurrence-free:

/www.mskcc.org/nomograms/prostate/post-op

As you can see from the following, his odds of successful salvage go down dramatically after his PSA reaches 0.2:

/pcnrv.blogspot.com/2016/09/very-early-salvage-radiation-has-up-to.html

He saw his GP today and asked his opinion as well and he said he thought .1 was fine for going on 5 years after surgery. He said he saw no reason to go before the recommended 6 months but I think for my own sanity, I may get him to go in July at 3 months. I guess idk what the plan would be if it does get to the .13 that his urologist doesn't want it above. That would lead them to believe there was a recurrence but if that's the case do they then take a scan to see where it may be or is there some kind of standard treatment plan for it? He has done so well all if this time and his post op pathology results were all good....

Most scans are usually useless at a PSA that low. A CT scan of the pelvis may detect any suspiciously enlarged lymph nodes. Prostate cancer almost always follows a very typical spread pattern: first to the prostate bed, then to local pelvic lymph nodes, then to the bones. When caught early with good pathology, and there are no enlarged lymph nodes, they usually give salvage radiation to the prostate bed only. He may be able to just have a short-term adjuvant hormone therapy with it, or even none at all. That judgment would be based on his pathology report, the slowness of the progression, comorbidities, and his preference.

BTW - I've never seen this PSA benchmark of 0.13 - where did he get that number from?

Thank you! That helps a lot. I have been so terrified that if the PSA got to the detectable point that it could be in the bones already. I apologize for my ignorance on this topic. I have literally worked myself up so much to the point of not feeling well the last couple of days. It's good to know that with close observation, the doctor's should be able to keep things under control. I suppose the fear grows from living in a small town and recently having a close family friend diagnosed with prostate cancer that is now in his bones. Of course his had spread before he even knew he had prostate cancer. Sorry for the babbling. I really do appreciate everyone's knowledge and input. Dad is still ok where he is now....I'm getting ahead of myself, I do know that. The C word is just terrifying to even think about.