Actually, my situation was a little more involved.

Having first heard about PSA testing when I was 40y (in 1995), I started having PSA tests as part of my annual health checkups when I was 45y, and watched my PSA slowly rise each year (1.30, 1.64, 1.79, 1.87, 2.10, 2.60, 2.70, 3.40, 4.00 & 4.20). So, it wasn’t a big shock to me in April 2012 (at 56y), that my urologist told me that my “blind” biopsy showed low-grade, localized prostate cancer: Gleason 6(3+3); an independent second opinion confirmed this.

But, since it was only a 3+3, there was no need to panic or rush to a hasty treatment decision; I had time on my side. (Note that this was well before the availability of PSMA PET scans, and PET CT scans were generally not approved for initial diagnosis. So, we were reliant on MRI, CT, and bone scan results for any indications of metastasis.)

With no medically-necessary reason to treat (and after a thorough evaluation of the data and literature), I chose AS. I was on AS for about 9 years, not only tracking PSA (every 4-7 months) and biopsy (about every 2-1/4 years), we also regularly calculated the lesser-tracked numbers (% Free PSA, PSA Doubling Time, and PSA Density), as well as obtained OncotypeDx and Prolaris biomarker (genomic) test results in order to keep my AS truly “active.”

After about 9 years on AS, my Gleason reached 7(3+4), PSA reached 7.976, and a Prolaris biomarker test indicated that I had “exceeded the threshold for active surveillance.” That was my cue to leave AS and seek active treatment.

I ultimately chose 28 sessions of proton radiation + SpaceOAR Vue. Prior to starting treatment, a 2nd opinion increased the Gleason to 7(4+3), so we added 6 months (two 3-month injections) of Eligard.

I’ve had minimal adverse quality-of-life side-effects, which was my intent with my initial choice of AS and then proton radiation treatments. Now at 4 years post-treatment, PSA hovers between 0.35-0.55. My most recent PSA test (2-1/2 months ago) was 0.478; not bad for still having a prostate.

Today, it’s as if nothing ever happened - just walked through a door, got treated (28x), and then walked out the door…..it’s practically back to the way it was before the prostate cancer journey started.