Without trying to confuse your case with someone else’s, I’ll cite this other post for your consideration.
And this one:
My late wife had breast cancer, which is admittedly a quite different beast than prostate. After her initial surgical + radiation treatment we entered a series of years of maintenance meds and active surveillance.
Problem was the surveiling was not highly effective with the result that the first anyone knew anything was amiss she had disseminated metastases here, there, and a few other places for good measure. Her cat was well and truly out of the bag.
At which point we were screwed. A lot of effort gave her a number of good years after that, then some less good, and then finally 2 shitty ones, then it was game over. She was 65.
Overtreatment of incipient cases is most certainly a risk. And side effects of that treatment, whatever they are, are real.
For myself I am of the general view that “surveillance” needs to be real active and real frequent to avoid an escape like we had. probably more active than is practical for most patients. Again prostate is generally pretty slow moving, but she had one of the slowest moving BCs they’d seen. But once it was out on the loose, there was no turning back the clock.
I don’t yet have a PSA problem. My Dad did have active prostate cancer before he was my current age. So I am actively watching this in myself for my sake, and fully intend, if / when active cancer is found, to take the more aggressive treatment approach and forgo the active surveillance. Is that smart? Hell if I know. But speaking only for me, it “feels” right.