Hi, Steve here and my first post.
I'm now 66 and had RP in 2020. My diagnosis was T2(c)N0M0, Gleason 3+4, 5 from 31 cores affected, pre op PSA of 6.1. LHS nerve sparing but long term ED disappointingly. However recovered really well and undetectable PSA (done at my local main hospital) of always ‹0.1. Seeing as I'd gone more than 2 years since op we agreed to leave it 12 month till next blood test. Just had it done 6 weeks ago and it's 0.2. A repeat test after four more weeks is now 0.3. Now I understand due to the lack of a second decimal place these two readings could be as close as 0.24 and 0.25. However they could be as far apart as 0.16 and 0.34. We'll never known, but because two successive readings of equal or greater than 0.2 is I believe considered treatment failure I fully expected my surgeon to refer me for a PSMA PET scan and Oncologist. However he wrongfooted me by saying
'normally we might have a scan and then see what lights up and treat with RT. But, we might not find anything, and treatment at this low level is 50% unsuccessful plus adverse effects of the RT. Another approach is to treat with hormones. However that wouldn't happen till PSA around 10, which could take years. By then I'm less bothered about sex and I've not had to endure RT.'
That being the gist of what he said made me feel I was being encouraged not to rush to have scan plus RT(guarding against overtreatment) versus let the cancer take hold but knock it back with hormone therapy if and when. After voicing my concerns I opted to repeat PSA after six weeks.
I'd be grateful for any thoughts or advice on this dilemma. My current feeling is to push to consult an oncologist and ask their view, especially on getting the scan. I understand my surgeon's concern is quality of life but treatment from now on isn't his main area of expertise so I should get a better steer from the oncologist.
Sorry it's a bit of a tome but I'm grateful to anyone who may read and comment.
Thanks