My comment will be more..."direct". I agreed with my own physician: "Active Surveillance" is a waste of time. Your biopsy revealed that YOU HAVE PROSTATE CANCER, even if it is just, say, a Gleason 3+3 = 6. Why wait until it is worse? It's like knowing that you should change the oil in your car between 3,000 - 6,000 miles, but you "want to wait" and change it at 12,000 - 15,000 miles. Good luck. Now you likely have major problems with your engine because your filter is solid sludge and your engine is paying for it. Your cancer is only going to get worse during the two years...whether slowly or aggressively, and the problem is, YOU DON'T KNOW WHAT "YOUR" CANCER IS GOING TO DO. I offered before that the Gleason score and the biopsy barely scratch the surface of what is really going on with your cancer. Neither the Gleason score or the biopsy will tell you if you have Extra Prostatic Extension ("EPE") where the tumor has broken through ("Extended") outside the membranous capsule that contains the prostate. If you have EPE you will very likely have "surgical margins" after surgery...your urologist couldn't get "all" of the cancerous tissue. "Right now" your tumor may be confined within the capsule, but if you wait with Active Surveillance, your tumor may have broken through the capsule, and now you have EPE. You are now one of the unlucky 10-20% with surgical margins, who have cancerous tissue still inside you, slowly growing until your PSA eventually exceeds 0.2 ng/ml which now makes you a candidate for 40-days straight of radiation. The Gleason score and the biopsy don't tell you if your tumor has Cribriform gland tissue: sheets of prostatic tissue that have visual holes like Swiss cheese. This is a more ominous sign about the degree of pathology. Your Gleason score and biopsy don't tell you if there is bladder neck invasion, or lymph node invasion. I learned this: EVERY PROSTATE CANCER IS DIFFERENT. That is why you must insist on getting the Decipher Test as well, to screen for 22 prostate-specific/associated genes that will yield a score that tells if of your risk of recurrence and survival at 5, 10, and 15 years, and...if you have certain genes like BRCA that will determine the course of action that needs to be taken. It is just my personal opinion, but this whole "Active Surveillance" thing only exists because prostate cancer grows slowly...BUT IT IS STILL GROWING AND GETTING WORSE, AND IT WILL NOT JUST "GO AWAY". Why would you want to allow that to happen? I know a lot of men are lazy, and a lot of men have fear...fear of mortality and fear of surgery under anesthesia. But in my personal opinion, you are only fulfilling your worst nightmare by hiding behind two years of Active Surveillance. You might be pleasantly surprised that your cancer is still a Gleason 3 + 3 = 6 (I doubt it), or maybe a low-intermediate risk 3 + 4 = 7 at, or even after, the two years, but...it could also be a 4 + 4 = 8 or a 4 + 5 = 9 or even worse a 5 + 4 = 9. And now it is in your bladder neck and lymph nodes...maybe your bones. Sorry if this was harsh. I say this because if I had insisted on Active Surveillance after my doctor said "NO" to it, I'd be in deep, deep trouble in two years. My seemingly "not so bad" cancer with a Gleason of 3 + 4 = 7 with just 6-10% of cells rated as "4", shocked my doctor when the pathology report was sent. I did have EPE. I WAS one of the unlucky 10-20% with surgical margins, with cancerous tissue left in my body because my surgeon didn't get it all. I WAS one of the unlucky people with Cribriform gland tissue. And I was one of the unlucky ones who, because of EPE, saw the cancer spread to my left seminal vesicle although all cells were rated as "3" with no focal tumor or nodule in/on on the seminal vesicle. So I went from what my urologist thought would be a low-grade "barely" a T2 cancer, to a much more ominous pT3b because of all of that, most importantly the seminal vesicle invasion. That is the tipping point. Even though both seminal vesicles and vas deferens are removed with the prostate, a pT3b cancer nearly always recurs "within" five years. It's just the way a pT3b is. If I had gone just on my Gleason score, and waited with two years of Active Surveillance, I could have seen that cancer spread to my lymph nodes and bones. Sorry again for the harsh tone.