Biochemical recurrence

Hello Bertie, I’m afraid I don’t know enough about biochemical recurrence after prostatectomy to answer your question ( my husband went down the ht/rt route). However I know there are people who posting here who can answer your question. I am replying so that post is bumped up to the top and not overlooked by those people who might be able to give you more info.

i hope all goes well for you.

Many thanks for taking the time to respond to my question.  Hope your husband’s treatment went well.

Hello BertieBB .

My husband has experienced recurrence but after RT plus ongoing HT so I can understand your concerns. The definition of recurrence is different after surgery compared to radiotherapy, as is the treatment initially available but the intent is to still effect a possible cure. There are many factors which influence the possibility of a recurrence but it appears to occur within 20 and 38 months after surgery in between 20 and 40% of men. The T2c is classified as intermediate to high risk dependent on the system used which would have put you at higher risk of recurrence which is usually classified as a PSA of 0.2 after a prostatectomy, or 3 consecutive rises, plus the velocity of those rises. With your current PSA of 0.04 it is unlikely that anything would show up on a scan - the most sensitive scan is a PSMA PET CT scan but they don't normally do these until the PSA reaches a minimum of 0.2, but is more accurate above 0.4/5. A recurrence is normally caused by a small area having been missed by the original surgery or some cells may have escaped into the lymph system prior to the surgery. The question is, what is the normal treatment and when is it best to act. The first line of treatment could be salvage radiotherapy of the prostate bed plus possibly the pelvic lymph nodes and the experts will take in to account your risk factors of initial PSA, Gleason, histology, and how well you have recovered from the surgery.... when making their recommendations. When to act is a bigger conundrum. Some believe it is better to act as soon as you have 3 consecutive rises in PSA even though there may be no visible evidence of cancer. Others believe in waiting until the PSA increases to a level where the site of the cancer can be seen with scans so that a more targeted radiotherapy can be given just to that area. At the moment it is too early to say whether you should be concerned as the PSA might just tick along at your current levels and no action would be recommended. I have attached a link to a video which can explain things a lot better than I can. It is American but most will be relevant to you.

https://youtu.be/JXRhzi0Z6qQ?si=kkM6mavgz3Tr0F3a

Many thanks for your reply.  I found it and the video for which you gave the link very helpful.

BertieBB. It’s easy to say but forget about for now if you can. There are thresholds that will be looked for. From my experience you are now where near them at the moment. Enjoy your success so far and don’t worry about the what ifs or might be’s. 
I know someone who was .30 from start after removal of prostate. Two years ago and being monitored only. 

Thank you once more.  I’ll try to follow your advice and enjoy all that I have going for me unless or until I’m informed I’ve reached a threshold.