I don't see any reason to change course.
Certainly not from your PSA...values of 4 to 10 ng/mL are considered the "gray zone." Yours is not high, but above the common threshold for investigation (which you have now done, and are monitoring).
Certainly not from your fPSA...at 23%, that's darned close to the value where you shouldn't even bother having a biopsy
Certainly not from your most recent biopsy...tiny, tiny, tiny amounts of 3+3
Certainly not from your earlier mp-MRI...PI-RADS 3...along with your biopsy results, you appear to have a small amount of insignificant prostate cancer, which is a natural part of aging
Your case seems perfect for AS!
There's some great study published by Dr Klotz (are you familiar with Klotz?) about
the psyche of men on AS. It definitely got "easier" over time which he assigned to two main reasons: First, most men learned and understood the disease much better and more thoroughly over time than they did when they were first diagnosed, and in learning more about
it they understood how low their risks were and that men on AS who advance later to treatment have the same outcomes as men who went into treatment right away...so they realized there was really no downside to AS itself. Second, the men on AS over time saw more and more of the needless side effect suffering that their cohort peers who sought treatment had to suffer, and gained increased appreciation for their choice. Both of these factors made it "easier," but both required the perspective of some time passing from their initial AS decision. Check out some of Klotz's writings...
Post Edited (Blackjack) : 3/7/2019 11:26:13 AM (GMT-7)