So i had my meeting with Dr Zelefsky, it was pretty much what i expected. I think the most important thing that i accomplished was establishing myself as a patient in his office, so that if and when i do need SRT, i will hit the ground running.
So his basic comment on my situation was that he thinks its possible that i am recurring (nothing i didnt know) but he wouldn't go so far as to say that its probable, YET.
He wants to see a series of rises, and right now my PSA is too low, and only one rise, after the first one.
He said that he is not a believer in the magic number being .1 for starting treatment. If he sees 3-4 rises in a row, and I'm .7, he will likely recommend we get started.
Regarding my "How the F does this happen with my pathology?" rant, he commented that while i had negative margins, the fact that i had a positive frozen section, that was then turned into a negative FINAL margin, tells him that my negative margins could be "questionable"
Regarding HT in conjunction with SRT, my impression was, probably not, but that could change. He was sort of non commital, he said that generally they use HT with SRT with higher PSA's (Not sure if he was referring to my presurgery PSA of 4.3, or the fact that we are on it currently and would hit it early, if it kept going up. But he also said, there are ongoing studies in this regard.
I told him i was surprised that the nomograms showed that my chance of success was 53% without HT, but 73% with HT. He commented that he doesnt put a lot of faith in the nomograms, because for example, its only a small number of men in the database that have the same exact stats as me, same G, same pathology, same PSA, etc. So its not that meaningfrul to an individual
The one action item he suggested is that i get an MRI in the next month or so, to have as a baseline . Which i will do.
Aside from that , he suggested i continue to be followed by Dr Tewari, my surgeon, who he spoke very highly of, and that we keep an eye on things, and another couple of rises, i should come back and see him.
Oh, and he did a DRE, which he said felt "smooth" and unremarkable (my word). Dayum, i though ti was done with that SH!T!!!!! He didnt do a PSA though.
So i guess nothing more to do but retest as scheduled in August, and otherwise just sit back and relax. And continue to worry
I'm nervous that at the current rate, two more PSA's take me to November and if they both rise, i will need treatment in January, which will screw up my plan to spend the winter at my new home in Florida. That would REALLY SUCK.
Ok, now i'm just venting, so I'll stop.
I waited 2 hours past my apointment time. Thats the only negative.