Slowly increasing PSA from 2004 to 2011 (2.5 to 4.5) then several sharp increases and decreases during the next three years. At the end of 2013 my PSA was back down to 4.8 and at age 67 with a PSA unchanged in 3.5 years I decided to ignore it for a while. My Internist, who I had seen off and on for 10-years, raised no objections to me ignoring my PSA test results.

My wife and I had retired in 2000 and were still, in 2013, busy living aboard our sailboat and exploring the west coast of North America. We were also very involved in mountain bike and road bicycle riding and it was very easy for me to "pretend" or "ignore" my potential prostate cancer problems.

Finally in May 2018 we had settled down in SW Florida, purchased a home, and became responsible land lubbers again. That process involved finding a permanent physician and getting back onto regular medical checkups. My new Florida internist insisted I have a PSA test done and the results came back at a shocking 9.4 (age 71 at that time)

After much drama and many tests, which clearly showed I had at least a bunch of G7 prostate cancer, I chose to have the prostate removed via Robot Assisted Laparscopic Prostatectomy (Late August 2018). The pathology report showed G7 (3+4), Positive Surgical Margins (single focal

Recovery was uneventful and I was back on my bicycle doing 25-hard miles a day by the end of November 2018. I took up Pickleball early in February 2019 and was playing 3-hours a day of very serious pickleball by early March.

At 10-months post surgery I have almost 100% continence and only suffer very minor leakage during extreme physical effort, (i.e. pickleball but none while riding the bicycle).

My post-RP PSA values are all less than 0.03 but the three three-month tests since early January 2019 all show a slight increase.

Both the RALP surgeon and my Medical Oncologist tell me that Radiation Therapy will be necessary at some point in the future but it maybe years before I need that radiation.

At this point in time (11-months after the surgery) I have NO physical symptoms or side effects and it is very easy for me to forget that I am a Prostate Cancer survivor and that I will need to keep an eye on my PSA scores for the rest of my life.

My µPSA was 0.018 four months post-RALP. It increased to 0.035 at 16-months post-RALP. The rate of increase diminished a bit and appears to now be stabilizing to a very small number. My April 2020 µPSA was 0.055 and 0.060 in July 2020.

At this point, early August 2020 & 23-months post-RALP, my Medical Oncologist wants me to just keep getting an µPSA every three months and waiting to see if the PSA values stays below 0.1. I have committed to beginning Salvage Radiation Therapy when my PSA value exceeds 0.1 in two consecutive tests, three months apart.

My MO had been pushing me to start SRT during mid-2019 but was willing to put off that treatment until we knew more about the upward trend in my µPSA.

I had my post-surgery cancer (PCa) tissue tested by Decipher Genomics in order to get a genomic profile. Decipher reports a 0.47 value for my specific cancer. That is 0.01 points above their LOW risk category for metastasis. Decipher reports there is about a 4% chance of my PCa metastasizing in the next 5-years and less than a 5% risk of a cancer specific death in 10-years, which would be my 82nd year of life.

Other research shows that given my CAPRA-S score, my particular pathology, coupled with the Decipher score - I have a very, very low risk of future metastatic PCa or a cancer specific death. Therefore, I am very happy to defer the SRT decision.

My physical recovery from the surgery is complete. I seldom have any urinary leakage and my sexual function is about 80% of what it was prior to surgery.

I am now 6-years past my robot assisted prostatectomy. My ultra-sensitive PSA values tested in April of each of the last five years are:
0.048 2020
0.045 2021
0.079 2022
0.082 2023
0.195 2024

My June 2024 discussion with my medical oncologist determined that I would wait until December 2024 to have another PSA test. At that point we will discuss the possiblity of further treatment.

I will be 77 at that time and in pretty good health. Most life expectancy programs suggest I can expect to live another 15 to 20 years so more treatment many be worth considering.

I still play very active pickleball five days a week for at least two hours of actual play each day. I do have minor urinary continence issues which are easily managed with a light pad. Other than that - my prostate cancer has had no discernible impact on my life.

Jerald's e-mail address is: svmirador AT gmail.com (replace "AT" with "@")