My sister just sent me an interesting study on AS done by Johns Hopkins. Can't link it because I read email on my iPhone.
Not sure if anyone else has read it, but reading it reinforced that even its proponents think it wise to consider this if you're on the older side and even then, if your gleason is low. I interpreted low as being 6 or less.
I read from it that if you are expecting/planning to live 15+ years it may not be a wise choice.
I forget the exact percentage, but it also said that something like 40% of people who start out with AS end up having surgery within 5-7 years ( might have the years wrong ). And I think those numbers come from groups of older men anyway.
So in my case, I'm 40, with a gleason of 7 ( 3+4) even the AS proponents seem to think AS is an iffy idea.
I'll read it more carefully when i get home and open email on my laptop, but that's what I got from it.
I know this board actively promotes AS, but the above seem to be good reason for guys like me ( young, low to intermediate scores) to really have honest and sincere doubts about AS.
It also seems that the biggest rationale given for promoting AS is loss of quality of life functions. That is no doubt a huge concern. I'm sure everyone here who underwent surgery had many a sleepless night over it and listened to their docs mention of it. But when you consider that many overcome these, some quickly and some slowly, and that others have various remedies at their disposal, it seems genuinely wise for some to opt for surgery nonetheless.
I think AS is a great option for older people with manageable disease. My grandfather had prostate cancer, monitored it for a few years and then at one point his urologist told him to stop even monitoring it as he would die of something else. That's what happened. But people in their 40s and early 50s? I wish them well of course, but it seems so risky to me. I'm sure our personalities have a lot to do with our decisions anyway. No way would I be a good candidate for AS based on that alone. I wanted the bloody thing out of me. It was toxic and I wanted it out and a chance for a new start.
Anyways, sincere good luck to anyone who chooses AS.