Observacion, prostatectomia o Radioterapia? AS, Surgery or Radiation?

A Gleason 3+3 is not really considered cancer. Most people would go on active surveillance at this point

I am not sure it is available in your country but a PSE test could figure out whether or not you actually have a problem with cancer. A biopsy may not have gotten samples from areas that actually have higher Gleason scores, Or you might just be a Gleason six and can wait until it may or may not get worse

Bienvenido, Igor.
Yo sugiero pregunta a su doctor sobre una prueba de DNA del tisú de su biopsía. Hay varios tipos. Yo tuvé una prueba se llama ONCOTYPE DX. En esta manera su doctor puede saber que es la agresividad de su cancer. Otros tipos son Decipher, Prolaris, ArteraAI Prostate Test, Opko 4K, and Genomic Prostate Score (GPS).
Bueno suerte, compañero.

Translation:
Welcome, Igor. I suggest you ask your doctor about a DNA test of your biopsy tissue. There are several types. I had a test called ONCOTYPE DX. This way your doctor can tell how aggressive your cancer is. Other types are Decipher, Prolaris, ArteraAI Prostate Test, Opko 4K, and Genomic Prostate Score (GPS). Good luck, buddy.

Ojala haya estas pruebas aca. Voy a consultar con mi urologo. Estoy agendando citas con otro urologo y un oncologo y he enviado las laminas de la biopsia a otro patologo.

Dificil decision. Hay que informarse lo mejor posible antes de tomarla.

Te agradezco tu aporte

Un abrazo

Parece que no hay PSE. Seguire buscando. Estoy recabando segundas opiniones y duplicando los analisis para ,ojala, tomar la mejor decision

Gracias por tu valioso consejo.

Un abrazo

Some info

The EpiSwitch Prostate Screening (PSE) blood test is a prostate cancer screening test that combines a PSA test with epigenetic markers to improve the accuracy of prostate cancer detection:
How it works
The PSE test analyzes a blood sample for the presence of PSA and five epigenetic markers associated with prostate cancer. The raw data is then fed into an algorithm to determine if the patient has prostate cancer.
Accuracy
The PSE test is 94% accurate at predicting the presence or absence of prostate cancer. This is an improvement over the standard PSA test, which has an accuracy of 55%.
Availability
The PSE test is available in the US for men being screened for prostate cancer.

A link to the test
https://www.94percent.com/

I posted a reply in the forum with details of the PSE test.

Gracias Jett. He escrito a los laboratorios mas importantes y a varias asociaciones de medicos a ver si alguien tiene estas pruebas. Veremos.

You can also get a Decipher done of the biopsy cores. My understanding from talking to a lot of doctors is that at 3+3 and your age you sound like you'll be on active surveillance or perhaps a short radiation. The Decipher will tell you if your current 3+3 is accurate or not. You have to remember that the biopsy is not comprehensive, it's a sample from across the prostate so you could be 6 or you could be 9 and the core didn't sample that 9 area. An MRI would give more information, as would the Decipher, which can tell you if the genetic makeup of your cancer is likely to be worse than the cores indicate. On mine, I was 3+4(7) and on the bubble of active surveillance, which was the treatment plan, until the Decipher showed 0.68 high risk for being worse than the cores indicate, prompting RARP.

"Thank you for your comment. Here in Peru, there is no Decipher. I only have access to a contrast-enhanced CT scan. Do you think it will be enough?"

Bienvenido desde Peru, @igor1821 . Creo que lo mas posible es que sigues con observacion, pero si habia la posibilidad en tu contexto, podrias tambien considerar estrategias de ablation (usando radiacion, frio, ultrasound, o laser, etc., obliterar los sitios de cancer conocido.) La otra posibilidad es removerlo en completo. El razon por escoger esto seria que sigues ya varios anos con la presencia del cancer indicado y algun dia es bien posible que pasaria afuera del prostate o se cambiaria a algo mas peor. Tambien removeria su HPB por completo :-).
Ojala que Dios te guia en tu decision y te bendiga en la vida que tienes de dia en dia.
Si escoges la surgeria (radical prostatectomy) es bien importante hallar medico con lo mas experiencia en eso que se puede, siendo que se mejora los resultados con la experiencia. Quiere decir que quien ya lo ha hecho 500-1000 veces lo va a hacer mejor en general en comparacion a cuando lo estaba haciendo los primeros 100 veces, etc.