Quandary

Hi Ketchup. I'm sorry that you have had to come here but welcome to the forum. A few details about your PSA, Gleason score and staging would help us to give you the best advice.

I was diagnosed at the age of 71 with PSA of 15, Gleason 4+5=9 and staging of T3A N0 M0. I was offered surgery or HT/RT and chose the latter as I am very active. I had 20 sessions of RT in Feb/Mar 2019 and have just finished three years of Prostap injections. So far all is well as my PSA is undetecable but things might change as the last of the hormone treatment depletes.

Good luck with whatever treatment path you choose and please come back with any questions you may have.

Hi Ketchup,
I was 57 with a psa of 8 and gleason 3+4. After active surveillance, a year or so later, psa was at 12 so I took the advice of surgery.
All is well 7 years on, but psa has been detected and is now at 1.4. I've been offered a deep psma scan after which I may need radiotherapy.
There's no 'right' way other than taking the specialist's advice.
My brother, with a higher psa, was told that surgery was a bit too late so after HT and RT back in 2012, he's absolutely fine.
Active surveillance is ok for a while until you adjust to the prospect of some intervention, however I think there will have to be an intervention. Don't stress about it because the outcomes are almost always good. Loads of people here will give really good opinions, even though we have taken different paths.

Hi Ketchup

I was 54 and I chose active surveillance. That was over 4 years ago. So far so good.

David

Hi

Always a tough decision, in my mind active surveillance does not cure the problem, taking it out might at first cause a few problems, but that’s explained by the oncologist or surgical team, if I had the chance but mine was to far gone ( incurable ) I would definitely have it removed.

Stay safe

Joe

Hi Ketchup

I think if your doctor has suggested active surveillance i would definately take that route for now. All the very best. Pate53

To horribly over-simplify, active surveillance in the elderly is because they have a very good chance of dying of something less unpleasant before the PCa gets nasty. But active surveillance in the younger patient is about keeping the weapons dry until you know they're needed. But if they're needed, they're needed.
"We've only got 200 rounds of ammunition, Jim"
"Don't shoot until you see the whites of their eyes, then make every shot count."

Warning: Real life isn't as simple as analogies ... but you get my drift.

The key to active surveillance is 'active'; you will need to ensure that you get regular blood tests, and that you report any untoward symptoms. You need a urology department that is efficient, and a GP you can trust. 

Early stage prostate cancer is curable (though you'll never know for sure that you're cured), but once it has been allowed to progress, that option may be gone.

Never think of active surveillance as the 'easy option' - it isn't for the faint hearted, and if it isn't done right, it can turn you into a nervous wreck!

It's also well worth reading the 'toolkit' for general advice.

I was on Active Surveillance from 2016 until Feb 2020 ,my initial PSA was 8 .6 rose over 3 years to 12  and in the Spring of 2019 I was taken off 3 monthly checks and put on 6 monthly because it had dropped to 10.6 .However at the 6 month check it had suddenly jumped to 21 so I had to have a prostectomy .All the scans prior to the operation were good no bone mets no indication of spread outside of the gland. But after the operation my psa didnt go down and remained at 17 which was rapidly climbing because when I started salvage adt and enzalutimide it had reached 28 .I opted for AS initially because I was frightened of the operation and a the nasty side effects incontinence etc .However I was back to normal after the operation within a month and have been fine ever since .The salvage treatment has reduced my psa to undetectable and there it has been for the last year .My advice to you would be due to your young age (I was 65 when Dx ) to go for AS but be very very proactive about your psa tests and not stay on it as long as I did .Prostate cancer can appear to be a pussycat for some time but as in my case can change very quickly into a tiger and take off .

You will get lots of good advice on this forum it's a very helpful one 

1. Let us know what you decide everyone's cancer is different and you have to work out what's best for you .