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If I had 1 core out of 12 with Gleason 3+3 = 6 , I would immediately request a 2nd opinion of my Pathology Result . Additionally for your Doctor to suggest RARP or Radiation up ffront is very concerning . IS HE A UROLOGIST or your GP. ?
I don't know a Urologist who would propose this treatment in your circumstance .
Get a 2nd Urologist opinion in addition to a 2nd Pathology reading .
On active surveillance " Regular scheduled PSA , Plus an MRI 1 year out from your original diagnosis to determine if there is any change in your tumor . If so , this would be followed by a 2nd Biopsy . Always a current MRI before each Biopsy .
Read Dr. Patrick Walsh's 5th Edition Book " Guide to Surviving Prostate Cancer " -- Educate yourself . Buying this book will be the best money you will ever spend .
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I appreciate your concern. Perhaps I miscommunicated.
My urologist proposed no treatment at this time. He proposed Active Surveillance in light of a clean MRI report followed by a biopsy result of 3+3=6, 40% of 1 core of 12 . Grade Group 1.
I was relieved that my MRI was clear. We proceeded to do the biopsy out of an abundance of caution. I had an elevated PSA of 6.4, which had risen steadily from 4.5 two years prior and from 5.5 one year prior. Prostate size/volume was small and PSA density was high.
We will do another PSA 3 months from now.
I agree completely that another MRI one year after the first biopsy/diagnosis is the best next step. Here's hoping that MRI is as favorable as the first.
I have read Dr Walsh's book you referenced and it has served me well in preparing to be a full participant in my health care decisions.
I am age 72 and in excellent health overall. I do want to understand why my PSA readings are elevated and gradually increasing and I wonder if the mostly favorable biopsy results fully explain the unfavorable PSA trends.