I’m weighing in to share my own path. My PSA number trended up last year from previous tests but remained under 10. My urologist, after a DRE, suggested a biopsy which showed one “hot spot” graded at 3+3. At this point I’m leaning to active surveillance. Before deciding however, doc suggested an MRI which subsequently showed a “shadow that shouldn’t be there w 3+3.” This led to a second biopsy which showed a total of 5 hot spots; three 3+3s, one 3+4, and one 4+3. Game changer.

I’ve read that this path is not unusual at all giving the “hit and miss” of a biopsy. This all led to a bone scan which, thankfully, came back clean.

I’m 66 and have chosen a radical prostatectomy for Sept 14 (allowing my prostate to calm after the biopsy). I’d be lying to say I’m 100% confident this is the way to go. There are clearly side effects to any chosen path forward that each of us must evaluate for our own situation.

My point? Read all you can. Ask every question you can think of asking. Talk to friends and friends of friends who’ve walked the PCa path before you. Then, along with your wife, make the best decision for you. It’s not the same for everyone.

I wish you all the best of luck. May you each have the comfort of loving friends and family to support you and the benefit of a talented medical team to work with you.