Isn't a biopsy supposed to confirm or deny suspicion?

[JohnSJ]

10. Active Surveillance is NOT worthless. If the gleason grade is a 3+3 and small volume, the next step

would be to do one of the genetic tests to determine how much risk there is.

As for PSA, it is just a data point, and not necessarily diagnostic, since there are many reasons for an elevated PSA, including benign things such as riding a bicycle, having sex within 48 hours of having a blood draw, to an enlarged prostate, or prostatitis, etc.

The biopsy is the only way to determine what one is dealing with, and if it is low grade, it is very prudent to do Active Surveillance.

Active Surveillance is NOT "watch and wait". You monitor it.

Prostate surgery or radiation is a major deal, and the side effects can be very significant.

The whole school of thought in dealing with prostate cancer has changed significantly from 20 years ago. Every major comprehensive cancer center in the country will suggest Active Surveillance if the grade and volume merits it.