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Treatment After Radical Prostatectomy Or Not?

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Subject: Treatment after Radical Prostatectomy or not?
Date: 11/21/2007

Hi - We are evaluatint whether or not to undergo external beam radiation therapy after my husband had a radical prostatectomy, since the grade of the tumor went up from the pre-operation biopsi (Gleason score 6) to the biopsy of the actual prostate that was removed (Gleason score 4+3= 7). The cancer is a T2c. At 6 weeks after surgery he has a PSA of 0.2. There was a positive surgical margin though apparently no infiltration of seminal vesicles or lymph nodes.

We wonder what others out there with experience or expertise would recommend? Should we wait for the PSA to rise and then begin external beam radiation therapy? Or not wait for this given the stage of the cancer and 0.2 post-op PSA?  The treatment available in our area would use a radiation beam of 70Gy.  Can anyone advise us of likely side-effects?

My husband is 67 and is nearly 100% continent after the RP, but erectile function is still absent. It was good before the operation so we are hopeful for a return of erections one day, though are aware it may take a while.

Thank you very much for all sharing of thoughts or experience to help us with this decision!

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