Surveillance is generally recommended for patients with exclusively pattern three disease until proven otherwise.

“if you have a smidge of pattern four I'm talking about 1 millimeter 2 millimet in total we think okay maybe surveillance would work for this person we have a very thorough detailed discussion age other issues in their life etc etc we determine okay life expectancy so if you're 75 and you have 2 millimeters of pattern four and you you know you're average US male maybe you don't need to aggressively treat at that time you need to aggressively monitor but don't need aggressive treatment”