New diagnosis at 50

Welcome to the Club that No one wants to join. This forum is great and the Information I've gotten here is amazing and the members are also Amazing. I was diagnosed in Feb and had my RARP in May. I had two places that were both Gleason 8, they were ruled High Risk Aggressive. I'm fairly certain my dad had PC but was never Diagnosed and never was treated. Keep doing your own research and like all of us, you aren't alone in this. All of us have a different perspective journey. From your Scores, etc. you caught this early and your options are better.
My Post op path report came back with a lower Gleason score of 7 and the grade was reduced from a 4 to a 2. I also had no spread. I was very happy about that.
If you haven't yet get a PSMA/Pet scan and MRI to determine of your PC is contained in the Prostate. That's Standard before Surgery.

Welcome and so sorry you had to find your way here. My experience is completely different from yours in that mine was full blown metastatic at diagnosis, so take this with a grain of salt but...

If, knowing what I know now, I found myself in your position that early on, that damned thing would have been gone faster than a fat kid can eat a Snickers.

Many doctors do not consider Gleason 3+3 to be cancer. They even stopped doing PSA tests for a few years because people are being treated with a 3+3 when they didn’t need to be. Your doctor is spot on giving you the recommendation he’s given you. You do need to get regular PSA tests and maybe annual biopsies, But there is no reason for you to do anything right now, based on the information provided by a number of doctors.

Here are some videos you can view about doctors that recommend active surveillance for their patients.

Here is a video with Dr. Laurence Klotz, one of the experts on active surveillance. He can give you answers as to why you would or would not be a good candidate for active surveillance.

From your description, 3 + 3 and active surveillance is not uncommon in this group. And, as Jeff said, many doctors don't even consider that cancer these days.

I'm glad you got it checked early and your doctor will be your guide to any steps in the future, but you got the result that many on this forum wish they had.

Listen to jeff's advice below..you are not gonna die anytime soon !! in fact, you may never need to treat your PC at all..but it will need to be monitored, no doubt..worry should not be on your menu !

Listen to Jeff’s advice. I was diagnosed at 51 and if it had been Gleason 6 I would have opted for AS. What I don’t understand is what your doctor means by saying that the risk of an upgrade is ourdated information. A 12 core random biopsy can still miss any existing pattern 4 in the same way as it did years ago. You could ask him what has changed in diagnostic techniques to make that claim.

I'm sorry to hear about your situation. Active surveillance makes sense. By the time we found mine at age 56, it had already metastasised to my spine (stage 4): despite the so-called "common wisdom" that prostate cancer is a slow-moving cancer, some types do develop _very_ fast.

As others have mentioned, Gleason 3+3 doesn't usually count as full-blown cancer, but it is a strong warning sign (pre-cancer, if you will), especially with your family history. If you start getting bloodwork every 3–6 months on active surveillance, and regular imaging on top of that, they should be able to catch it the moment it starts to change (*if* it ever starts to change), even if it's one of the aggressive varieties.

Best of luck!

Hey, sorry for your bad news. I understand your unwillingness to just sit and wait for full-blown cancer that needs treatment to appear. When I consider what happened to my father, I would never, ever advise anyone to opt for active surveillance. You are just 50, kinda early for any kind of prostate issues, and your father had PC which means it is probably coming...Only way to stop it is to remove it before it even becomes cancer, just like women opt for breast removal if positive for BRCA mutations. Yes, surgery is not as simple, you could end up with life-altering side-effects, but no cancer in your future. My father started having prostate issues at 65 (same time as my grandad), he was first diagnosed with BPH, opted for transurethral resection first in 2016, which only increased his urine flow, but did nothing for his 5x getting up at night to pee, so I knew there was more then just BPH, By the time biopsy finally confirmed diagnosis in 2019, COVID happened, every other disease was on hold, so when he finally started treating it it was already outside of the prostate. To cut the story short-he died 6 months ago from sepsis he got from chemo. My grandad had his prostate removed when it started being an issue, he was 2 months away from being 100 when he died (kidney failure from wrong dose of heart medication). I curse the day my father had his resection, if it had been removed in 2016, he'd still be here, instead I was robbed from 25 more years with my dad. Yes, over-treating it is a serious issue, but under-treating it is deadly! My dad could be a poster boy for that....

Thank you everyone! Jeff, I will watch those videos tonight. It’s tough, as you all know. I fully understand that I am “lucky” with my diagnosis and am as grateful as I can be with a cancer diagnosis. I understand AS protocol and believe the science, hopefully I have the bandwidth to be patient and try to live with it. As my buddy said to me, “you’re not 8 years old, no one is making this decision for you”. And that what’s tough, the decision. Damned if you do damned if you don’t. In regards to what my Dr stated about prevalence of worse cancer post removal. He stated that the commonly referenced stat of 20-30% is relatively outdated and that the study that produced those numbers had participants that already knew there GS had changed. Dunno, it’s just what he said…. Again, thank you all!!

" My Dr said the info that 20-30% of post removal biopsies coming back a higher score is dated and skewed? " My biopsy was 3+4, Prolaris test put me on borderline to treat or watch. Sent biopsy slides to John Hopkins they confirmed 3+4. I went to Mayo, had an MRI, then surgery, and thank God I did. Once my prostate was out and the pathologist could thoroughly examine the whole thing, I was actually 4+3, tertiery 5, cribriform, and perinural invasion. This was in Sept of 2023 so in my case my pathology DID result in a higher score after RALP. I wer as upgraded. Now, maybe your doctor made that statement assuming everyone gets a guided targeted biopsy. However, unfortunatly, Trus random biospies, which I had, because I didn't know any better, are still very common. I don't think Mri guided targeted biopsies had been around long enough to have a RCT's to prove that doctors statement of skewed and dated.