As far as your cousin's situation goes, do you know if he has any PC in his family, i.e. father, uncles, brothers, etc? Do you know any more about his PSA history other than his current number? I.e., has it jumped up fast in the past year in particular?
The 1 core of 12, with <5% Gleason 6 sounds good at this point, but he needs to understand, that a biopsy is an estimate at best, on what is actually found. There is always the possibility that there is more cancer, even with 12 needles, the one positive core could have been right on the edge of a large area of tumor. THen of course, his one core might be all there is.
There are several men here at HW, that are doing AS, not sure I remember reading of any that is 10 years out though. AS is not about doing nothing, its about careful monitoring, including very regular PSA readings, DRE's, and if warranted, additional biopsies over time.
As far as the aggressivess issue, too many variables there for a straight answer. Depends what strand of PC your cousin really has. The "3" cancer cells in a Gleason 6 may or may not mutate and turn into "4" or "5" cancer cells over time. Most times, it could take years for this to happen, but there are also agressive strands that can make this transformation in a matter of months.
The smaller and earlier that a cancer like PC can be located, the better the chance as a general rule that it can be treated and erradicated.
On the surface, without knowing any other information, it would seem like your cousin could beging with AS. Has he gotten at least a second opinion from a radiation or medical oncologist? Or has he only been seen by a urologist or a uro/surgeon?
Good luck to him, and bring us up to date on his situation.
David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence: 1 Month ED: Non issue at any point post surgery, no problem post SRT
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one: July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped 9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4, Caths #11 and #12 same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in