@tdoriausername (You know how much of that PSA score is simply age-related BPH by tracking the PSA Density.)

I’m not (yet) that jaded to believe that a doctor’s recommendation is that self-serving, During my 14-year prostate cancer journey, there have been no less than a half-dozen decision points where we (my doctors and I) weren’t in agreement on my treatment path.

I’m convinced that their recommendations to me were based on what had worked well for them in the past. (“If all you have has been a hammer, everything looks like a nail.”)

When their argument was stronger than mine, we went with their recommendation; when mine was stronger than theirs, we went with my recommendation. These were not difficult discussions, and I never felt pressured (or scared) into following their decision.

In my case, I knew that watchful waiting was not the right choice for me; active surveillance was the right choice. (Watchful waiting is only used when someone is too old, too sick, limited life expectancy, or too (anything else) such that treatment risks outweigh benefits. I had none of those conditions, and was more than able to handle the rigors of keeping my active surveillance truly “active” so, that’s what I chose.) The term “active surveillance” has been around long before 2012 when I chose that path.

Mayo Clinic has an age-based PSA chart (see attached).

At a PSA of 10.3, the scientist in me would want to dive into what’s going on. I would work to rule-in or rule-out conditions like enlarged prostate, BPH, prostatitis, UTI, or a dozen other possible causes of an elevated PSA. At the same time, once I had ruled out all other reasonable possibilities, I wouldn’t be so fearful of it being prostate cancer that I still summarily rejected the possibility and did nothing….