Welcome AtTheLake. I can't answer your insurance question.
Regarding active surveillance you may be aware of this, but in case you are not, I wanted to point out that you fail to meet the Johns Hopkins criteria (www.urology.jhu.edu/prostate/advice1.php
) for AS, i.e.:Very Low Risk Prostate Cancer
Life expectancy less than 20 years
Cancer not felt on digital rectal examination (stage T1c)
PSA density (PSA divided by prostate volume) is less than 0.15
Gleason score is 6 or less with no Gleason pattern 4 or 5
No more than 2 cores with cancer, or cancer involving no more than 50% of any core on at least a 12 core biopsy Low Risk Prostate Cancer
Life expectancy less than 10-15 years
Cancer not felt on digital rectal examination and/or small nodule (stage T1c or T2a)
PSA below 10ng/ml
Gleason score is 6 or less with no Gleason pattern 4 or 5 on at least a 12 core biopsy
There are other, more liberal, guidelines out there but I wanted to point this out as you already have a significant volume of disease and at your age it seems very likely you will eventually need treatment.
As you also may be aware there is about
a 30% chance that you have higher grade disease that was not picked up on the biopsy. Do you know your ADC values from the MRI? These can give insight on the likelihood of aggressive lesion...
Jan '13: PSA 1.23, small nodule on DRE (1st screening @ age 40)
Mar '13: Biopsy 2 of 12 cores GS 3+3: rt mid 10% and rt apex 20% w/ PNI+ Stage cT2a (confirmed by Epstein @ Hopkins)
open RRP by Dr. Burnett @ Hopkins. Both nerves spared.
Final Path: GS 3+3, organ confined (tumor extent moderate), SV and 11 nodes all negative (pT2a), clear margins!
PSA: 0.01 @ 6 wks, <0.01 @ 21 wks.