No treatment for prostate cancer improves your life. Not one.
You accept the certain yet varying degrees of degraded Quality of Life (euphemistically called "side effects"), to offset a greater risk of harm from the primary disease.
So, what's the harm of a tiny G6? How long will that take to progress to a dangerous situation, and would you be likely to miss that it's headed that way? That's the whole point of AS. It's ACTIVE surveillance, not pretending that it's not there.
He's 44. That's very young. There are some issues with surgery; it's a major surgery with inherent risk, also incontinence, and impotence. For example, what does the urologist mean to be "continent"? Generally, leaking urine at a rate of one pad per day is considered continent. Really? I sure wouldn't accept that definition, but your urologist/surgeon will. The prostate is the junction block of the entire genitourinary system. Everything down there is either in it, on it, or runs through it.
And impotence is a real risk. The rates are higher than the medical community admits. Again, at 44, compromised or even ruined sexual potency is a real possibility. So for the rest of his life, dealing with significantly compromised sexual ability? And a removed prostate means dry orgasms. Ok, but another significant change.
For the risk of those "side effects", there had better be a major danger that's being fixed. But a tiny G6? It's just not like that. I would hope the doctor would be responsible enough to address your husband's fears, and get him through the "GAAAAA! Cut it out of there!!" phase.
This is exactly why the USPSTF discouraged PSA testing. People may freak out over such a low risk situation; it would have been better for them never to have been diagnosed. I don't agree with their recommendation, since it misses detecting guys with truly serious situations. But still, wWe have to help guys recognize that a tiny G6 does not warrant the life-changing side effects likely from surgical treatment.
55@Dx on 4/16/13. PSA 5.2, G9(5+4), PNI+, cT3a by MRI.
IGRT - 44 sessions (79.2 Gy, 50.4 Gy pelvic)
ADT2 - Lupron+Casodex (5/13-3/16)
8/13-5/16 <0.1 (ADT2)
5/16-3/17 recovering from ADT2
3/17-7/18 ~ 0.6 - 0.8 (no TX)
10/18 = 1.0, 12/18 = 0.9My Story