Just diagnosed, intermediate risk: Not sure which direction to go

Totally agree more men need to know that surgery complications are tough to deal with, just try to let your body fight it off before rushing to surgery like I did to just get it out. Aka Risk vs Reward for me the risks far outweigh the rewards

Before you make a decision, consult with a Radiation Oncologist. I had SBRT (5 sessions) radiation in October. So far, so good.

Many thanks - I will!

I have been off this forum for a while due to caregiving needs for my older sister, who has been a paraplegic for 31 years and lives alone. We love about 90 minutes apart, which is a blessing since she was recently given “months to live” due to chronic bone infection that came from multiple body sores and pressure wounds typical for paraplegics. I need to be around to drive her and lift her in and out of her chair at appointments. I have not told her of my PCa as she has enough on her plate. I am 66, good health, diagnosed with 3+4, CHEK2 variant, PSA 2.5, PSA density 0.075, 33 cc prostate, contained in prostate according to PSMA PET, father had PCa and died at 89 yo. Been on AS since Dec 2025. Just received my Decipher results after a couple of attempts at getting it done, scoring 0.54, intermediate risk. Being treated at Dana Farber in Boston, a top cancer center. My doctor and I spoke yesterday about Decipher and the need for me to start treatment, but I shared my caregiving needs to my sister, and he feels I can wait 2-3 months to see what happens with her situation. Was leaning towards surgery, but with CHEK2 and Decipher score, I think I have a higher chance for recurrent cancer after surgery, so I am now wondering if I should just do radiation and hope it gets it all. I do not want to go on hormone therapy, so not sure which treatment gives me the best odds of no recurrence and best long-term prognosis. Welcome any input from those on here with intermediate Decipher scores, CHEK2, or other similarities. Thanks!!

If you have low grade 3-3 cancer and lesions are near each other you may be a candidate for cryo ablation. Far less traumatic than RP, which I just had. I regret not going for the ablation 3 years ago. ( With my doc it’s an office procedure that would have taken maybe 20 minutes). Make sure your doc is highly skilled and get a second opinion if you are unsure.

My 2nd MRI showed nothing, but a 2nd biopsy showed 2 cores, 1 at 3+4. I decided on surgery. My pathology report came back at 4+5. Margins clean, lymph nodes clear, slight EXE. I had zero incontinence. I have had 6 psa tests < 0.01 since. My suggestion to you is do what is necessary to make sure your numbers are accurate. Best wishes.

I’m Gleason 3+3, decipher .50 and PSA 20. I’m 77 years old and continuing with active surveillance which I have been doing for over twenty years at a center of excellence. I tentatively figure the risk of the cancer metastasizing in ten years with a .50 decipher may be around 15%, but I’m still researching that issue. It is hard to get accurate information on the amount of risk to which one is exposed by a .50 decipher score. On the other hand the social security stats predict I have 50% chance of dying from any cause in ten years. I am doing detailed research before making an irrevocable decision. This research takes a lot of time but there is an enormous amount of good information on the internet and YouTube. I have heard a reputable doctor on you tube say to the effect that the risk of 3+3 metastasizing is miniscule. Once one gets their bearings on what the issues are he can even access the actual scientific studies that can inform decisions.