@kyndats
if your biopsy truly shows you are a T3 then it means your cancer has grown outside the prostate. This doesn’t seem to correlate with a Gleason 6.

You need to discuss this with your doctors? You don’t want to go on active surveillance if you’re truly a T3.

@kyndats What I learned is prostate cancer is a disease that has many different twists and turns because we are all different, different specialists, different opinions, and different goals and needs individually as the patient.

In my case, I placed my trust in a “centers of excellence” urological dept at an American medical school. My urologist was a professor of urology and prostate cancer. He was the director of all the residents desiring to become one day a urologist certified by their Board. Everyone of my exams had a residence involved. The professor was teaching his resident about my case. Therefore, I concluded logically I was getting best exams and advice.

Subsequently I learned my first biopsy by the professor was a failed cultivation of pattern 7 cancer. He didn’t get the needle into the core of the tumor, even though it was a MRI Fusion biopsy. The MRI he used was PI-RADS 4. When the biopsy returned G6, there was this discordance with the PI-RADS 4.
I subsequently learned in my case I needed a new biopsy like in 3-4 months later for a redo and the professor to try again to get the needle into the core where pattern 4 cells linger.

In my case it was a 2nd biopsy 2 1/2 years later that returned G3+4=7 because the professor got the needle into the core that time.

I learned therefore I was really at the time of the first biopsy G7 grade two, stage T2a. I had a misdiagnosis, but exercisable as there was no proof the professor committed any negligence. There is a percentage of times urologist just don’t collect the cancer cells. It can be hit and miss.

Another thing is G6 alleged benign cancer findings as to the tumor isn’t the end of the story. G6 can grow bigger and bigger overtime. They grow bigger and bust through the thin capsule. That is called extra prostatic extension EPE.

That alone is a threat because possible pattern 4 cancer cells are potentially exiting the gland and are outside the gland.

So that situation might warrant RRP, or radiation. Some American doctors will do focal therapy in that case, but many will not. Urologists disagree on that problem.

Both standard treatments RRP and radiation have risks and complications so choosing one over the other is very individualized as the patient’s choice. There are many factors to consider both kinds of intervention.

I would say make many appointments for second, third opinions and make a choice. Of course, costs for services can be important to those having deductibles and co-pays. So some patients just can’t get all the extra consults and diagnostics over money issues and insurance policy benefits.

Good luck, and the good news is everything is early in this case, so that you can count on heavily as living a very long life.