@fritzo I think what was initially most beneficial to me was in the mid-1990s coming across newspaper articles (like the two I’ve attached).

From those I became aware of the importance of early and annual PSA screening. Starting in June 2000 (at 45y/o), I began annual PSA tests and monitoring this just as I would any other blood assay.

Over the next decade, I watched my PSA slowly creep higher each year. So, it wasn’t a big shock to me in April 2012 (at 56y), that my urologist told me that my biopsy showed low-grade, localized prostate cancer: Gleason 6(3+3).

I think that over those 12 years I became somewhat comfortable with PSA results - just as with my cholesterol, LDL, HDL, triglycerides, etc. results - No reason to panic or worry that my spouse would be widowed. Simply take it in stride and look for the next diagnostic test.

One important option developed during the time that I was on active surveillance - and I mention this humorously as well as seriously - is the development of rectal spacers for radiation treatment in 2015. Prior to that they used endo-rectal balloons that were inserted and removed at every radiation session - while still leaving the anterior wall of the rectum fully exposed to radiation. (Sounds pleasant doesn’t it?) Today, the rectal spacer is injected just once, lasts through the entire treatment, and reduces radiation to the rectum by up to 70%.

Technology-wise it was the development of Pencil-Beam vs. Passive Scattering systems. Being able to apply proton beams layer-by-layer, delivering a highly conforming dose that matches the exact shape of the tumor, and protecting adjacent healthy organs better than the older scattering methods (taking further advantage of proton’s Bragg-Peak characteristics).

I’m glad I waited…..