It’s good that you’re in information-collecting mode. That will guide you towards an appropriate decision.

> It’s always a good idea to get 2nd opinions on biopsies — not necessarily because you don’t trust the 1st one or don’t like that opinion. But, because much of the interpretation of images and scans is often as much an art as it is a science, and it’s dependent on the skill and experience of the person reading the slides. It’s good to have an independent set of eyes reviewing the biopsy.

> Since you have a “4” cell type in the Gleason score—> In the MRI or biopsy reports, were the words cribriform pattern, extracapsular extension, seminal vesicle invasion, perineural invasion or intraductal carcinoma mentioned? (If not, that’s good.)

> also, ask them to calculate your: % Free PSA, PSA Doubling Time, and PSA Density to see if those are ok or if they indicate any concern.

> the genetic (germline) test will check a few dozen markers that may be related to prostate cancer in addition to BRCA1/BRCA2. (See attached chart for the key markers.)

> I would also ask to bump-up PSA testing to every 4-6 months rather than annually (and calculate those three - % Free PSA, PSA Doubling Time, and PSA Density - at every PSA test). Tracking PSA more actively going forward is important.