@handera

Yes, my husband had yearly MRI, yearly PSA and yearly digital exam. PSA went up and down but trend was very slowly upward. His prostate was getting bigger with age so PSA slow rise did not cause much concern for his urologist. The last MRI showed lesion on the right getting SMALLER and than tiny one appeared on a left side and that triggered "suggestion" of doing "maybe" a second biopsy .

I would not wish to my worst enemy to go through a shock that we endured this year 😵‍💫😱😱 !!!! Having 4+3 unfavorable shortens recurrence free period and increases possibility of metastases, not to mention cribriform and IDC. Having gleason 9 puts one in HIGH risk for BCR in short period of time no matter the treatment one chooses ! I wonder if you ever checked those prediction nomograms 😞.

I have no idea why do you think we would not have 6 good years if he did have RP earlier ??? We would DEFINITELY had much better 6 years than we will be having now living in fear of BCR that is maybe going to happen in the next 6 mos ! 😢 (god forbid) .

Once your cancer becomes of higher gleason it is completely different story and different long term survival.

What does it matter that his recovery was fast and that his PSA is undetectable when now we are talking about months before possible BCR, while with 3+4 we would be thinking about a decade or even more !? I do not understand how you do not see how huge difference a gleason score alone can make and not to mention that NO MRI or PSMA can see or detect EPE , SV invasion etc, etc.

I wish you the best of luck and please 🙏 have biopsy every year or 2 and Decipher every single time ! It changes, it all can change without much change in PSA or size of lesion. Our urologist relied on PSA and MRI and the first genetic test that showed very low risk. There was no need for confirmation biopsy since at the time 3+3 matched genetic test results, lesion was small and only 2 cores had 3+3, all the rest completely clear. Even with his terrible results at the end - less than 10% of his prostate had any cancer , a biopsy had a single core with 4+3. Post RP pathology confirmed that - extremely small tumor burden, but gleason 9 because they also found comedonecrosis and nothing else meters now. He has high risk for BCR in short period of time 😭, I am sick to my stomach just thinking about it.