I don't proactively or all the time say it but when I sense the timing is right I do bring it up,

I find that many hold the perception of overtreatment based solely on a PSA test, which to be fair, there has been a history of the medical community jumping into vice active surveillance when warranted.

So, when I bring it up, I also briefly highlight that it is just one piece of the clinical data needed that if their PSA is troublesome then there is a process and time to gather additional clinical data in making any decision.

Sometimes they ask about that process and i try and be brief but walk them through it, biopsy - MRI vs TRUS, genomic testing, 2nd opinions, the GS and risk groups, active surveillance...

The trick is not too much but not too little information. Their eyes can glaze over quickly with the former.

Kevin