What combination of clinical and pathologic features would lead you to be comfortable recommending active surveillance in a Gleason 7 prostate cancer patient?

Active surveillance (AS) is an important option for prostate cancer patients, especially for low risk prostate cancer. For intermediate risk prostate cancer, the risk of AS increases somewhat but the benefits of AS remain. To keep the risk of AS acceptable, one should select intermediate risk patien...

The patients need to be low volume, favorable-intermediate risk cases. Increasingly, I am getting Decipher testing on patients in the NCCN IR category. If they have clinical factors of IR yet Decipher shows low risk of progression, then I will offer AS. I also tell patients a repeat biopsy in the fi...

As MRI research unfolds for use in AS (perhaps instead of repeat biopsies yearly), I grow more comfortable having images to assist in the decision, in case the scan suggests higher risk, larger volume disease than identified on biopsies and by PSA, esp. in anterior prostate where biopsies often don'...