You'll get different bits of advice, I'm sure.  I'll just give you my
experience.  I am presently 67.  My RP was on 5/1/02.  My post RP PSA was
3+4.  3+4 cancer cells were found in a fibro-adipose tissue outside of the
prostate.  Seminal vesicles were clear. One nerve spared.  The uro said that
salvage radiation would threaten my regained continence and eventually
erectile function.  I decided to wait and watch.  Only if the PSA goes up
would I have the radiation.  Last week I passed the 3 year mark, and my PSA
is still undetectable.  I am basically continent and erectile function is
close to what it was before.  For what it's worth---my decision and my
experience.

Fred,

Listen to your Doctor. He will have a plan on what to do next. He should
have a good feeling on whether to do radiation at 3-6 months or just wait
and continue to check psa tests.

Two schools of thought you will find on this matter with research studies to
back it up.

1. Wait to see if there is a psa rise - then do radiation

2. Receive radiation treatment at 3-6 months due to a positive margin.

My initial decision was #1 to wait and see if there was a rise in psa. Why
get radiation if you don't need it.

Unfortunately, I had a rise 4 months after my RP and received radiation at 6
months.

If I had to do it all over again - I would still choose #1

Your cancer may have been killed at the margins. I was told it is difficult
for it to survive where is has been cut.

For now just heal and enjoy yourself

I spent most of my days, hours, minutes and seconds worrying about things
that never really happened - with this PCa.

Have some faith in your body's ability to heal and in the medicines and
treatments available to us today.

Stay healthy.

Dave P

"OCL" <oregoncatlover@yahoo.com> wrote >

Much depends on whether extensive PC research increases, or decreases, your
worry level.

I'm reassured by exhaustive literature research (even though my numbers and
prognosis suck) simply because then I know I've done all medicine (plus some
safe, tasty, but unproven dietary changes) can do to optimize my therapeutic
index (ratio of benefits to side effects) according to my criteria, that
from here it's out of my hands until my PSA starts rising again and I have
more decisions to make. Even during those months of research I never
perceived worry, because my PC is gonna do whatever it wants to do within
the boundaries of what *I* do to *IT*. Now that I've defined my QOL criteria
(a major effort in itself), exhaustively (many man-months) studied the
benefits and SEs of my treatment options, and chosen and completed my
initial and adjuvant (second) treatments, I no longer have a cancer problem.
I probably have CANCER, but since I've done all I can do about it without
incurring SEs I consider worse than asymptomatic hypothetical cancer, I
don't have a cancer PROBLEM until it comes back and demands further medical
attention. Knowledge empowers me, and takes the worry and fear out of this
PC nuisance. As a result, what my PC means to me now is that a) I wear funny
underwear and b) I slightly consider my prognosis when making very long
range plans.

Others seem threatened or frightened by too much information about their
cases and options.

You should be able to tell which group you're in pretty early into your
research. As you read those first couple of PC books, does the information
you're learning makes you feel better, or worse?  I'm a vigorous 61-YO for
whom my athletic sport is the most important activity in my life, and
learning that my odds of living another 5 years are <15% ticked me off. But
in those same books I learned what to DO about my cancer, and what the
various treatments could do FOR me and TO me. The tradeoff for me hands-down
favored further research. IOW, extensive, intensive reading made me feel
BETTER, not worse, despite the doom and gloom side of it.

You sound like you fall into the former category, so maybe you've passed the
first test on whether research is your path to treatment and inner peace.
Your faith should be a rock to lean on, too.

That touches on WHETHER to know. WHAT to know should emerge as you read. The
day my doc said, "You need a biopsy", I bought Walsh. By the time he told me
a few days later, "You have an aggressive cancer", I had read most of Walsh.
By the time I talked to surgeons in earnest, I was into my second or third
PC book and my 40th (?) authoritative website. My numbers and my developing
understanding of my case and its options steered my research towards some
chapters and let me skip others, saving me time so I could keep up with the
ever-expanding consults with specialists. By "keep up" I mean walk into each
new appt with pages of questions relevant to MY case. I kept them in front
of me during each consultation, checking off answers as the docs' comments
addressed them or asking them as appropriate topics emerged. That let us get
through a few typewritten pages of questions in just a few extra minutes.

Ultimately my research led to one specific initial treatment emerging as a
no-brainer FOR MY CASE. When the issue of adjuvant treatment came up after
that treatment, I went back to previously skipped or skimmed chapters and
website sections, read many more books and trials, and asked many more
specific questions of this forum and several specialists. I also had a staff
of specialists read and comment on my list of scores of adjuvant treatment
benefits and SEs. Again, a clear adjuvant treatment path emerged that
relieves me of worry. Not of the THREAT, mind you, but of worry about it.

If you're still reading this, you've passed the second test of whether
research will benefit you: patience.

My criteria, my questions, their answers, my conclusions, and lengthy (duh!)
discussions of all that appeared here last fall. If that interests you, I
can try to point you to them. But the main implication is that, IMO, nothing
compares to each patient doing his own research, because I suspect that only
that will empower and educate him sufficiently to make the right choices,
ask all the relevant questions, define the risks he chooses to accept, and,
ultimately, avoid being among those here and out in the real world who often
say, "If only they'd told me . . . ".

Sorry, but I just don't have the time to shorten this.

I.P.

I am not a doctor, but I would not invite radiation without significant
cause.  I waited until my PSA started going up and radiation was a breeze,
but it still has side effects that you don't want if you have a choice.

The 4+3 is a kick in the nuts, but if there is no seminal vesicle
involvement or lymph involvement, you're doing well.

Fred,

I'm not a doctor and can't advise you on what to do, but
I'll tell you my layman's thoughts about what you might do
and what you might ask your doctor.

On the one hand we know that radiation has side effects.
It will do further damage to your body, including some
permanent damage that may or may not be significant,
depending on the skill of the radiologist and the luck of
the draw.  So it's best to avoid radiation if you don't need
it.

On the other hand we also know that radiation is most
effective when used relatively early, before the cancer
can metastasize.  So if you actually do need radiation,
you probably want to get it as soon as practicable.

The issue is, and the question for your doctor is, what is
the best way to balance these conflicting considerations?

One thing that may be a good idea, the doctor is a better
judge than I, is to delay getting radiation until a PSA test
shows that there is still cancer in the body, but get tested
frequently so that you'll know ASAP if there is cancer and
radiation is indicated.

Maybe even once a month testing will not be amiss for the
first 6 months or so.

   Alan