Anxiety

Hello Al985 . Don't beat yourself up, it is natural to have fears where cancer is concerned. From my understanding, but remember I am not an expert, positive margins mean that you have a higher CHANCE of a recurrence at some point in time, but this doesn't mean that you will. There have been evaluations done comparing adjuvant vs salvage radiotherapy and the consensus seems to be to wait and see if the PSA indicates that an escape has actually happened. The reason is that adjuvant radiotherapy can result in higher incidents of ED and incontinence compared to salvage radiotherapy without conferring any extra benefit in terms of overall survival plus it could be over treatment. With the development of PSMA PET scans a more targeted approach can be taken, especially for those who have had previous radiotherapy but for those having a Prostatectomy it has been shown that men can be kept on the curative intent pathway if action is taken once the PSA reaches 0.2. but before it gets above 0.25. With a Gleason 3+4 which has hopefully all been removed you are on the lower end of the scale so if anything has escaped already it would probably not show up for possibly a few years so it is important to stay vigilant with the PSA testing.

Hi my OH was in a similar situation but T2b amended to T3b and had entered the seminal vesicles.   The surgeon at post op said it was all gone and no follow up treatment needed.  His PSA reading was OK for 2.5 years but then started to climb.  He was put on HT in April and is nearly at the end of 37 weeks RT with only fatigue as a side effect.   It obviously was not what we hoped for but they are very positive that this treatment will see it off completely.  Please don't panic hopefully your surgeon removed all the necessary tissue from the margins and you will be fine.  If not there are next stage positive treatments.  Good luck

Hi Al985

I completely understand your anxiety and the irresistible temptation to look up Dr Google. I spent a lot of my career researching information and statistics and it's hard to stop doing it. However, it is best avoided.

Great advice from Alwayshope as usual. I'm not a medical professional but my understanding is that positive margins does NOT mean they didn't get it all. The trauma of the surgery itself can destroy cells on the margins so it may well be completely gone. Your PSA was undetectable so that's very positive. 

I certainly felt anxious at the time of each PSA test, but as time goes on this will lessen.

All the best.

Cliff