Here is Johns Hopkins’ protocol for active surveillance: https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/active-surveillance-for-prostate-cancer

That’s close to what I did: PSA tests every 4-6 months; repeat biopsies every 2-1/4 years.

Those nearly 9 years on active surveillance gave me time to thoroughly evaluate all treatment options and pick the one that was right for me - proton beam radiation. The plan was to not get active treatment until it was medically necessary. Gleason 7 is that point. The proton radiation treatments were relatively uneventful and I’ve had no lingering after-effects.

I’m now 3 years out since completion of proton radiation treatments. My wife later told me that if she hadn’t known I was undergoing radiation treatments, she wouldn’t have realized it from any change in me. (If I’m happy with the outcome, and she’s happy with the outcome, and our emotional/physical relationship is still solid, that’s a trifecta I can live with.)

With his family history of PCa, he should see if his doctor can order (and his insurance company will pay for) a genetic (germline) test to check for gene mutations. He may (or may not) have inherited any. If he can’t get the genetic test from his doctor or his insurance company won’t pay for it, he can get a free genetic test here: https://www.prostatecancerpromise.org/

I’m African-American. I’ve found that every test, diagnostics, treatment that I’ve had, has worked for me just as with anyone else. He should keep following standard protocol and not let anyone change his focus.

Once I decided on active treatment, every time I’ve done a PSA test, we’ve also tested testosterone levels and included CBC & CMP; every time. In fact, just this morning I had all those tests done.