Anyone following a wait and see with a Gleason 3+3

I've been on active surveillance for 4 years. Had my 2nd MRI recently and waiting for my 2nd biopsy. Just some random advice to offer (but surely I am not one of the experts around here), I like how your doctor is aggressive with active surveillance (for example, MRIs every 6 months, I wish my original doctor was that aggressive), seems like the quality of prostate MRIs can vary greatly, not easy to balance active surveillance vs the desire to treat, some doctors are eager to do surgery regardless of gleason/grade, make sure you have a biomarker done after biopsy (Decipher is one). Again, just some random thoughts. Hope all continues to go well for you.

If you review the recent medical information about a Gleason six you will find the medical community feels that people with a Gleason six are over treated. Staying on active surveillance is the optimal thing at this point, Unless they found some extenuating circumstances in your biopsy or heredity. You can look on YouTube for videos about it.

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.

Thank you very much Jeff. You should watch the videos Jeff M below posted. Very informational.

Thank you Jeff M. Excellent videos to better understand this situation.

I was one that decided to over treat. gleason 3+3, 1 out of 12 samples with cancer, PSA 1.1. Age 68. I convinced my Dr. into NSRALP. Father with an awful death from prostate cancer, grandfather, a brother. I decided i just wanted it out. Medicare paid for it. Post op 2 small lesions contained in the prostate , clean margins, 3+3, no lymph involvement. I am both incontinent and have ED issues. Its been 6 years clean PET scan, < .01 PSA. No other health issues. Did I roll the dice and win or did I roll the dice and lose. ? good question. Most times I wonder if waiting was the best answer.

I wouldn't second-guess your decision. Someone has to take *all* the risk factors into account, not just the Gleason score. Do they have germline mutations like BRCA1/2, that can make cancer more aggressive? Had their PSA risen rapidly between annual screenings (if they were getting them)? Do they have a strong family history of advanced prostate cancer?

In your case, the answer to that last question was "yes", so I think you were justified in seeking more aggressive treatment, for whatever my opinion is worth. But for someone who answered 'no' to all of those questions, active surveillance for 3+3=6 would likely make the most sense.

You’re doing the right thing with considering active surveillance. Here is additional information that will help guide your decisions:

> How old are you?
> What is your history of PSA results?
> What was your PSA Doubling Time?
> What was your PSA Velocity?
> What was your PSA Density?
> Ask the doctor for a genetic (germline) test.
> Ask the doctor for a biomarker (genomic) test.

I was on “active surveillance” for 9 years (2012-2021) before eventually deciding on active treatment.

Keep tracking it; you’ll do fine.

Thanks. would you mind sharing what Gleason and PSA you started with and what after 9 years changed that caused the treatment decision.

I just want to say (as one poster already did) that you have a great doctor and that I wish my husband had one like that. Active surveillance in your case is definitely a way to go and may your gleason 6 never become anything more than that.
My husband had only 2 biopsies in a span of 7 years and that was a huge mistake. He had MRI almost every year but MRI is not enough, unfortunately. As other members mentioned do both PSA and PSA free and ask for Decipher test after biopsy. Biopsy should be transperineal and MRI and ultrasound guided.

Wishing you all the best : )))

My recommendation is always get a 2nd, 3rd, or even 4th opinion, and go to a cancer research center like Mayo or Moffitt for ongoing treatment. They are THE experts on prostate cancer and are on the cutting edge. This is what they do, everyday, 7 days a week, 365 days a year.

I was recently diagnosed with Gleason (3+3) 6, PSA 5.5, biopsy (one cell positive out of 12). Decipher score LOW. I also have hypogonadism (body does not produce testosterone) and have been taking testosterone injections for a decade before my diagnosis and was stopped. Specialist at Moffitt Cancer Center put me on active surveillance and allowed me to continue taking testosterone injections - which all other urologists refused. But the specialist at Moffitt has other patients in his practice in my situation that are receiving testosterone and on active surveillance.