Is there a PSA value below which you would not offer salvage radiation post-prostatectomy?
If a patient's PSA goes from undetectable to minimally detectable (ie 0.03-.05) would you wait to offer salvage radiation? Would your recommendations change depending on whether patient had T3 disease or positive margins?
Answer from: Radiation Oncologist at Academic Institution
I am commonly asked the inverse question: if I use a "PSA cutoff" whereby a rise beyond this value will strongly favor treatment with post-op radiation. I think it is difficult to have a set value that applies for all patients, as the decision to treat should be individualized to patient and disease...
Answer from: Radiation Oncologist at Community Practice
An ultra sensitive test can detect rising psa before it meets criteria for failure. That being said, in context of margin positive, any psa elevation confirmed by repeat testing few months apart, should be considered for salvage treatment. Although, I don’t know if treating then or waiting for...