Trying to continue. Gleason was 4+3=7. PSA 4.0 at diagnosis. Primary treatment was RARP. PATHOLOGY AHOWED POSITIVE...

This helps me understand your situation much better.

Your Diagnosis Summary:

• Gleason 4+3=7 (intermediate-risk prostate cancer)
• PSA 4.0 at diagnosis
• Treatment: RARP (Robot-Assisted Radical Prostatectomy)
• Pathology finding: Positive surgical margins on the left side

This is significant information. Let me explain what this means and what typically happens next:

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What Positive Margins Mean

Positive margins mean cancer cells were found at the edge of the tissue removed during surgery. This suggests some cancer may have been left behind, which is why post-operative monitoring and sometimes additional treatment are important.

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What Should Have Happened After Surgery

According to the NCCN Guidelines for Prostate Cancer, after RARP with positive margins and Gleason 7 disease, your care team should have:

1. Monitored your PSA closely (every 3 months initially, then every 6 months)
2. Considered adjuvant radiation therapy (additional radiation to the prostate bed) to reduce recurrence risk
3. Possibly recommended hormone therapy depending on other risk factors

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My key questions for you:

1. After your 2007 surgery, did you receive any additional treatment? (radiation therapy or hormone therapy?)
2. What has your PSA been doing over these 17 years? Has it remained undetectable, or has it risen?
3. Are you currently under active surveillance, or have you lost follow-up?

This context will help me guide you toward the most relevant current information and recommendations.