“It’s time to pull the trigger…” My wife and I sat in silence, stunned after hearing this. I had anticipated some reassuring words and a suggestion to return in a year, not this. For the past 18 months, I had been on a program of active surveillance for a low grade, low volume prostate cancer. We were now sitting in front of Dr. Eric Klein, Chairman of Urology at the Cleveland Clinic and expert in prostate cancer treatment, hearing these words.