Hi Felix1 - sorry to hear about your diagnosis.  I've also recently been told that I've got prostate cancer (3+4), but thankfully localised to one side and curative with treatment.  I've been offered a robotic prostatectomy or brachytherapy.  They've not really suggested active surveillance, but it's there as a 3rd option if I really want it.

tbh, the options and their respective side effects are currently the things that are playing on my mind the most.  It's unfortunately a crystal ball situation and everyone is different.  I've used things like ChatGPT extensively to feed in my current general physical condition (age, height, BMI, weight, non-smoker, drink, exercise etc...), MRI, PSA and biopsy results, along with notes from meetings/appts with surgeons and oncologists - basically giving it as much information as possible.  I've then asked it to look at the various side effects and the chance of them happening - it uses general data from the internet, so it's not based on my specific results and whether I'd eg be incontinent.  It's generalised, but I've found it useful to do research and prep for appts with consultants.

One of the consultants said to me that going down the robotic prostatectomy route was front loading the side effects, whilst the brachytherapy was rear loading.  I appreciate this doesn't help you with your questions, but ultimately, it depends on how you feel about the side effects, the potential for them to hit and their severity, and you need to weigh that up against your age, your current health and where you see yourself in 10-15 years time.  Have they said that you'd definitely need treatment of some kind?

It's the worst decision ever - to quote Bart Simpson "you're damned if you do and you're damned if you don't"!!  For me, I think I want the cancer removed (as best as possible) using surgery and to move on with my life, knowing that the side effects at the start are the worst it'll be and it's down to me and the skills of the surgeon to see how far I get back to baseline (where I am today).

Hi many thanks for you reply. This is where i am fella:

i am 58 in 2 weeks never smoked i exercise and are fit an well with no symptoms at all my psa 7.3 mri scan showed 4 tiny leasons on left hand side contained 19 biopsys resulting 4 out of 19 are c ers my gleason scale is 3+3 low grade i may have it this for a few years but who knows advice was active servalance was my best option as it will be closely monitored every 3 months with blood te etc. my 1st one is in may like you said its not an easy decision either way just keep changing my mind  

Hi Felix - Sorry to hear that you're also in the club.  I was told that had my PSA been below 10, that they'd be more likely to consider active surveillance, but would still recommend some form of treatment given the 3+4, with the 4 driving agenda for treatment.

From my perspective, I'm not sure I'd be mentally strong enough to do active surveillance as I'd always be worrying about it.  By biggest fear is that it grows and becomes a metastasis cancer.  Knowing what I'm like, I'd be wanting almost constant PSA tests and MRI scans. :-)

Good luck with your PSA tests and your journey.