Hi @paulchen ,
I'm sorry to hear you're in our group.
Given what I'm reading here, it sounds to me like you would prefer to be aggressive in the treatment of your cancer. At the very least, you're questioning the suggestion that surveillance is warranted as opposed to treatment.

When I was diagnosed, I felt exactly as you do, "why aren't we doing something NOW!" My situation was a little further along so active surveillance wasn't really recommended but I'll get back to that anxiety.

If my assessment of your concern is correct, first thing I'd do is take the information you have and consider getting a second opinion. Not so much of the diagnosis but treatment options. Try to get an appointment with a highly rated cancer center to discuss your case. The anxiety that comes from waiting can be almost debilitating, was in my case. I had to go through phases of acceptance, sleep became a little elusive etc.. If you feel you would like to treat, tell your team.

Another minor side issue, If it was me, I'd tell your doctor(s) that I'd feel better with a PSA test in 3 mos as opposed to 6. 6 mos is a long wait to see at what speed (if any) your PSA is rising, maybe it drops a little, wouldn't that be nice to know in three months as opposed to six?

Having said all that....
"The Urologist recommends active surveillance. I'm due back in 6 months for 3 appointments for PSA test, biopsy and MRI."
It seems it takes this long to get appointments in some places anyway, for example it took me 4 mos to see the surgeon and radiation oncologists to let them each pitch their treatment and get my questions answered. Then it took another 3 mos to get my surgery scheduled. Soooo, 6 mos with the gleason of 6 and only 3 dirty cores, in the scheme of things, doesn't sound that long to me. The fact that you're getting the MRI seems like a good backup to surveillance, you can change directions if they find anything they don't like there. Just curious here, are they repeating the biopsy or doing another type of biopsy in 6 mos?

At your age and early stage, assuming reasonably good health otherwise, you have several options for treatment.

One other suggestion, perhaps when you are discussing initial treatment with your team, ask what would be the follow up treatment if the PSA starts to climb again? The reason I suggest this is, if you do some treatments to start the process, it may take some follow ups off the table. In my case I was told that standard radiation (as opposed to proton beam or other newer types) would damage the tissue enough so as to make RP very difficult and requiring a very high level specialist. I only knew to ask because my father battled this the last 35 years of his life, and lived to be 91!

Best of Luck and hopefully some more folks with more experience here can give you a little more support and information.