My PSA had climbed to 6.24 from 4.7, My PC referred me to a urologist, he ordered a pmMRI and a 4K score blood test, MRI was PIRADS 4 with a 12mm lesion and the 4K score max at 95. I then transferred to Mayo and they did an MRI Fusion perineal Biopsy, 23 cores, 6 with 70% Gleason 4+3=7 another 3 with 40% Gleason 3+4=7 and 14 cores benign. No other sign of cancer outside the capsule. I am 70 yrs old, my Dad had PCa at 63 but lived to be 90. After the biopsy I met with the Nurse practitioner, ( not the doctor) who gave me the results and said the urologist was recommending surgery, like I would just accept that and she said they would reach out to schedule. I said not so fast, I started doing tons of research, and I got them to do a PSMA PET which also confirmed the MRI results and I had them order a Decipher test, which I am waiting for the results of. Bottom line, I had to insist on the PSMA PET and Decipher, as I wanted all possible information before making a decision as to what treatment if any to have. I was leaning against surgery and after meeting with the surgeon, he said at my age I was not a good candidate, as it was MAJOR surgery, and recovery and complications could be difficult. I was relieved, as I did not want surgery, especially after asking him all the details. My prostate is 50.4 CC or grams, about the size of a lemon, and they just cut the whole thing out, not just the tiny area of the tumor which is only 12mm ( 1/2inch) and volume of .42 CC Since the Urethra goes right thru it they cut about 2 inches of it out with the prostate then pull down the bladder neck and pull up the urethra to re attach. Just a horrific thought, and shortens the penis by 1-1.5 inches. You have to wear a catheter for 2 weeks or more and you have a 10% chance of incontinence for life. NO THANK YOU Even after Radical Prostatectomy ( now I know why they call it radical) there is a 20-30% chance the cancer comes back. Then your other choice is radiation, poisoning your body and can also have side effects of incontinence and ED. Because the voulume of my tumor is so small ( not even 1/50th of my prostate) and my PSA only 6.24 I am meeting with my urologist to talk about Focal Treatments HIFU, Cryotherapy or even the TULSA PRO, it makes a lot more sense than surgery or radiation. Also I am in no rush, probably won't have any treatment until fall of this year, another 7-8 months. Even the experts admit that Gleason 4+3= 7 with a very small volume is not going to metastasize for another 5-7 years and then you have another 5-10 years before you might die from it. In other words, at my state right now, the 15 year survival rate might only be 10 % better with treatment than if I do active surveillance, or nothing. I have zero interest in living past 85 and would be happy to make 80 with no quality of life issues. Just my own personal opinion, each persons situation and life goals are different