Hi Vic, I'll be able to clarify a few things for you...
A diagnosis with only Gleason 3+3 findings is what the PC medical community calls "indolent" prostate cancer. In fact, there have been heated debated in the medical community as to whether this non-lethal diagnosis should even be called "cancer" because it often triggers unnecessarily aggressive, emotional responses by patients and has led to gross numbers of "overtreatment" for low-risk disease. So, regarding your mpMRI results, this imaging technique largely "skips over" indolent PC, but looks for clinically significant disease...so your PI-RADS score of 1 is outstanding and as low as it goes.
As someone else already alluded, PC is a natural part of aging...in fact THE MOST SIGNIFICANT "RISK FACTOR" FOR BEING DIAGNOSED FOR PC IS AGE...it's natural aging. Studies have shown that most men over age 50 have some sort of detectable PC...mostly indolent PC just like you which will never hurt them. In fact, most of those men have never encountered the set of circumstances which leads to a biopsy and they will never know they are walking around with PC, and will live full, complete lives. (I'm rather surprised, in fact, that--and this point is key--unless you had previous problems with your prostate at a younger age
that you even agreed--or that it was suggested to you--to have continued PSA testing, and especially a biopsy...but that's water over the dam at this point.)
That being said, I can see absolutely no good reason for your monthly PSA testing. Frankly, with your "indolent" finding at age 70, what you can comfortably know is that you will NOT die of prostate cancer. The rare lethal kind of PC has a very, very different signature than the common, run-of-the-mill natural aging you have stumbled across. So, not going to die, then one has to question the ethics of any doctor who recommends an aggressive treatment with your findings...with my 10-years of lay experience, I don't get that at all...truly an ethics concern, wondering if the RO is putting his own financial interests in front of the best care options for the patient, but note that there is a big difference between him saying "I recommend treatment for you" and "If you decide to have treatment, I recommend radiation treatment for you." If I was 70 and had just about
any type of PC and chose to be treated, I would probably have radiation therapy, too, due largely to age.
If you want to continue to track it through your AS program, the second, confirmatory biopsy 12-18 months after initial diagnosis is typical, and if the results are similar (they usually are) then it gives a very high confidence in the program.
Post Edited (Blackjack) : 8/15/2019 3:12:21 PM (GMT-6)