A few comments:

- IMHO “individual patient circumstances and preferences” ALWAYS trump even the best RCT’s.

- many folks equate “active surveillance” with “doing nothing”; when a true AS program is actually the opposite.

- the fundamental idea of AS is tied to the nature of low risk PCa….if/when the clinical/genomic evidence indicates unfavorable progression has occurred, usually defined by a confirmed biopsy of Gleason 4+3 (or higher) or a high risk Decipher score, THEN it is time to select a definitive treatment.

Of course, some men simply cannot bear the idea of any form of “cancer” being found in their body.

This is why some urologists and researchers advocate for a name change of Gleason 3+3 prostate cancer, suggesting terms like “IDLE” (Indolent Lesion of Epithelial Origin).

- the point of the ProtecT trial was to prove (as well as medical science is capable of proving) that there is no STATISTICALLY significant reason to choose immediate treat over AS for localized PCa.

In others words, one is NOT “rolling the dice” by choosing AS with low risk PCa.

….but low risk PCa folks are going to do what they want to do and and you’ll get no argument from me if it was simply a personal preference….just don’t indicate that “science” is the reason for their POV.