Posted 1/18/2021 1:41 PM (GMT -6)
Formal AS programs hone their protocols so that they catch indolent PCa that either progresses in Gleason grade or in quantity of G6. It's best to follow the protocol. After all, we don't ask our dentist to space out our checkups because no cavities were found. AS protocols vary. My uro refers to some AS programs as being "loosey goosey" -- I would stick with one of the stricter protocols. There may be some wiggle room within a protocol -- in other words, if it requires MRIs and biopsies within respective time ranges, you might push it to the end of those ranges, but beyond that seems to be flirting with danger. Remember what the financial commercials say to the effect that past behavior is no guarantee of future performance. If you do catch a progression to something clinically significant, you don't want to do so after having lost a few years and the great advantage of early diagnosis. Both MRIs and biopsies can miss clinically significant cancer; routine repeat testing is the countermeasure.
On a separate, but related note, if I were contemplating an AS program, I would have a genomics test OncotypeDx or Decipher) done on my biopsy tissue to make sure I wasn't in the small group of G6 men (perhaps 10%) whose cancer is at high risk of forming higher-grade lesions that may metastasize.