I had had a couple of urinary infections, and I decided to see a urologist. After examination, the urologist remarked that there were some hard spots in my prostate and that the prostate was very enlarged. He recommended a biopsy.

The biopsy returned with a diagnosis of cancer and a Gleason score of 3+4=7. The urologist recommended immediate removal of the prostate gland. He wanted to operate within a week. I was concerned about the rushed treatment he was proposing and told him that I wanted to wait a month or so until I was sure what path I wanted to take. That's when he said: "Mr. P, you don't understand... I can cure you!" That was enough for me, I felt he was trying to sell me a car.

I decided to request a second opinion, and I selected a new medical plan from a provider which relies on conservative approaches to medical practice and which is a non-profit with little incentive to do procedures that are unnecessary and contribute to raising their operating costs.

I requested the biopsy samples from the original lab and they were sent to the new provider's pathologist who returned a diagnostic of no cancer found. Considering that the sample from the original lab might have been mixed up with someone else's, I underwent another biopsy and at that time the pathologist found cancer with Gleason 3+3=6.

After meeting with the new provider's radiation oncologist and one of the surgeons I decided that my selected course of action would be "active surveillance." That is, do nothing except for PSA testing and a biopsy every six months.

I have since changed my non-treatment choice to "watch and wait." That is, do nothing except a PSA test every six months.

I have been following that regime for the last nine years. My PSA went up to 5.5 until I started taking finasteride (finasteride has the side effect of lowering PSA by about one half). Now, under finasteride, my PSA is 3.12 (effectively 6.24).

I believe that my cancer is very slow growing (at least so far) and I am betting that I will die from some other cause than prostate cancer. In the meantime, I am super-active in physical exercise (I ride between 80 and 100 miles per week on my bicycle) and I take very good care of myself nutrition wise. I am 74, and considering my age, still sexually active (twice a month or so). I am very contented with my decision and would not change it. It is quite possible that my cancer will metastasize, and I am prepared to accept the consequences.

We all got to die of something. There's nobody leaving this world alive. 74 is pretty good and with luck, I might last another 5 or 10. I don't think I want to live to be much older than that with all the consequences of advanced age.

It has been 10 years since diagnosis and I am now 75 years old. In the past ten years, I haven't had any treatment for my cancer.

I recently had an MRI followed by a focused fusion biopsy. The MRI shows a small cancer (1 cm by 0.5 cm) straddling one of the neurovascular bundle. The cancer is very near to the outer border of the capsule. The Gleason score was 6 for 1 core and 7 (4+3) in another.

After discussing the options with my urologist, I decided (with his full support), to continue watching and waiting. I have an appointment with him soon and will discuss my condition in detail.

I am feeling physically great. I do almost daily exercise (cycling). I seldom have sexual intercourse (though I get a fairly good erection to start out with). I wake up at night with very rigid erections, like when I was a young man. I masturbate about once a week.

I am very happy that I did not go the treatment route 10 years ago. Even if I have made the wrong decision and the cancer ends up killing me (rather than dying from another cause), I am prepared for that and will not second guess my self. The last ten years have been some of the best of my life.

It is now 2023 and I'm still following a watch-and-wait non-treatment course. I had a guided prostate biopsy about two years ago. It upgraded the Gleason score to 4 + 3. The cancer has grown but just barely. It is now 1.1 cm in size. My urologist recommended ADT to treat the frequent urination problem, but after reading the side effects I declined. I will be 79 years old in a couple of weeks. I am almost symptomless and I am hoping to remain so for a bit longer. I am not concerned about dying "early." For me, quality of life is the only consideration. I am aware that my cancer might metastasize and make me very, very ill. I am happy that I have had 13 years so far of a normal life with all the qualities of being a healthy male. I would not trade that time for the possibility of a cure with side effects.

Carlos's e-mail address is: cpereyra AT yahoo.com (replace "AT" with "@")