Diagnosed Today

Be sure to get a Decipher test done as well. Also, check over your MRI and biopsy results concerning cribriform pattern, intraductal involvement, extracapsular extensions, perineural invasion, and seminal vesicle invasion. All of those things affect your ultimate treatment plan.

It's fine to work some with your local medical services but always involve a high end organization as well that has achieved the center of excellence rating (COE). The big COE facilities have teams of doctors and technicians such that it is easy to get multiple opinions. A COE is also much faster at processing all kinds of tests than are local medical centers. The best doctors are definitely at COE facilities. There are 38 centers of excellence in the U.S. as seen here https://cmcnetworkmanagementtool.uhc.com/clarity-fhcp/standardNetworkMap.do

I too was a 3+4 with a high Decipher score and still chose radiation with good results. See my bio for more info.

Wishing you the best outcome. I can recommend Amar Kishan at UCLA, unless you can get to him first.

With as minimal a case of prostate cancer, as you have, active surveillance, makes a lot of sense. You could be tested in another six months and see if it’s gotten more aggressive, but you could go years without it happening.

Here are some videos from doctors about who should be on active surveillance. Getting prostate cancer treated too soon can be a real mistake.

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.

Active Surveillance for Intermediate Risk Prostate Cancer w/ Dr. Claire de la Calle | Ep. 288

I would agree with Jeff. Any time you can avoid doing anything to your prostate, I would do it( or not do it) . For peace of mind, a second opinion is not a bad idea. Now you might go to see somebody at MAyo and they might make so much sense, you might not feel the need. Keep us posted, my friend and best of luck.

It is always shocking - nobody expects to hear that they have cancer : (.

You got some good responses already, I just want to add that you should ask for Decipher test since it will help with your decisions.

If you do not have any cribriform or IDC features in you gleason 4 sample, you can take your time to explore future treatments.

If you decide to have AS please make sure to have a biopsy every year or year and a half going forward .

I would also get a GPS test https://mdxhealth.com/gps-physician/. This is similar to the decipher test but better for newly diagnosed localized PC, and help with treatment decisions. The decipher is better for recurrences after treatment. Best of luck

@copyman

You are completely wrong about Decipher.

It actually has some value after recurrence BUT is best done before ANY treatment is initiated since it can inform patient if AS is at all advisable.

It also helps with decision about adding ADT or not for initial RT treatment etc.

I was treated at Mayo and chose Tulsa Pro for my 4+3. Very happy with my treatment and results so far. Click on my profile for more info on my experience.

Optum, Inc., part of UnitedHealth Group, rates cancer centers with its Centers of Excellence program. It is one rating system patients can use to be reasonably assured of high quality cancer care. Descriptions of what patients and insurance companies can expect always seem to mention "cost effective", or "low cost". Anyone would think they would receive excellent care at one of these places.

Another rating system is provided by the National Cancer Institute. NCI has designated 73 cancer centers in the US. https://www.cancer.gov/research/infrastructure/cancer-centers

I'd not heard of the Optum rating system. A google search produced this comparison of the centers rated by the two systems:

"Many, if not most, NCI-designated centers are also selected by Optum as a Center of Excellence because they meet the highest standards of care. NCI centers generally have a heavier focus on research and new drug development, while Optum COEs focus on the efficient, high-quality application of existing best practices. Optum COE networks are specifically designed to reduce costs (by 25%–50%) for payers and patients"

What do I know? I thought it is a mistake to say all the best doctors work in one or the other of these centers. Great doctors are found all over the place - in the community, at academic institutions, private groups, and designated centers.

Sorry. We know the shock that comes with the news. You will get through this.