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I just have a simple question or two and likely missed it somewhere along this on-going discussion (which I am not sure the end-game point is); i.e., how does anyone know if they are low risk based on the randomness of biopsies? I have heard that the only way to know full pathology is to examine the gland after it has been reviewed?
Please refer to John Bonneville's response on " some further clarification" dated Dec 27 @ 7:59pm. He does a good job describing an AS monitoring protocol. If you had a high grade tumor that was missed by a needle biopsy and started to grow, your PSA , and imaging testing would catch it.
If you are asking what the end game is in this AS debate, IMO it is recognition, respect, acceptance and implementation among the PCa medical community at large, reflecting the fact that this strategy has proven itself to be a viable option for those that meet the criteria. Until that happens, we are going to continue to have a serious over-treatment problem worldwide.