Jon, since you asked....
The whole point of active surveillance is to keep an eye on things, and IF things change, THEN you treat. No, you're right, no one can guarantee that it won't change--but that is the point (and value) of AS: If it changes (and about
1/2 the time it does within the first few years), you treat then. If it doesn't, then you don't. The major value is that you avoid the stress, challenges, and potential side effects of treatment until it is truly needed.
Also, you have obviously heard one of the semi-truths of PC treatment, usually put out by surgeons: That if primary radiation fails, there are no secondary treatments available. Not true. Plus, with G6, your odds of having a primary treatment failure are miniscule--like less than 2% over the next 10 years.
If you're determined to have treatment--then don't let me tell you not to do it. Heck, I had surgery for G6, and my final pathology was G7--which happens about
10-15% of the time. I'm just trying to clarify some of your options. In short:
AS is there to keep an eye on things and discover if (or when) it changes, and treat then. There is NO apparent long term risk to AS: men who did AS have no statistically significant differences in long term outcomes compared to those who treated immediately.
Surgery or Radiation both have high likelyhood of cure for you. Focus on that and the potential side effects--not the very small chance of recurrence.
Age at Diagnosis: 56
RALP on 2/17/15, BJC St. Louis, Dr. Figenshau
58.5g, G3+4, 20%, 4 quadrants involved
PSA 3/10/15: 0.10
My Story: www.healingwell.com/community/default.aspx?f=35&m=3300024