Rising PSA after RP. What treatment?
I am now 65 and had an RP in Jan 2007. My surgeon, a leading Canadian specialist, was pleased with the post op bio. Nothing at margins, nothing in the nodes or in the other bits removed. He spared the nerves on the left side because pre op biopsy showed that area clear. However post op bio showed cancer on left side also and peri neural invasion.PSA undetectable for first nine months then slow increase. Now two and a half years later PSA at .2 I have moved to live in the U.K. and saw a specialist at a specialist cancer hospital in London. He reckons it to be impossible to detect any mastises until PSA at least 4.0. He also reckons that with all the negatives in the post op bio that the chances of the cancer being localised is very slim. His answer is to have radiation therapy on the off chance that it might help. He has also started me on androgen deprivation drug Bicalutamide 150mg (Casodex).He is the specialist but his opinion appears to conflict with my specialist in Canada who seemed to think he would do scans and tests at PSA of.3 Is it a good bet to go for six weeks of radiation just on spec?Can scans show anything at this stage?Would it be just as good to stay on the Casodex and do nothing else for now?I am also concerned that with peri neural invasion the cancer might be spreading through the spared nerves. The nerve sparing by the way did nothing to help re erectile dysfunction.. Views based on your experiences and knowledge are sort for.Thanks