Trying to get perspectives on what comes next

presently, you do not have enough information to panic nor to ignore your situation. I recommend that you stay busy and active and also get more information like a biopsy. Prostate cancer, if you have it, is a slow growing cancer. Be cool. Good luck

Shep247, the biopsy you want is a transperineal MRI fusion ultrasound guided biopsy. You might check to see what type of biopsy you are scheduled to have.
With Gleason 5, you will probably need treatment.
Following the biopsy you would have a PSMA/PET.
From the biopsy material you should request somatic testing of the genetics of the tumor. It will give you the mutations particular to your tumor. And give you an indication of the cancer's aggessiveness. There are several of these tests. The one I am most familiar with is Decipher.
All of this testing might take several months. Collect all of your records including images from the biopsy and PET scan. Because when you have finished testing you'll want to see a medical oncologist, surgical oncologist and radiation oncologist and a radiation specialist in proton radiaton in order to understand your best treatment.
I think it's best to look at the oncologists online and decide who you want to see. You can self-refer with your records, or ask your medical provider to refer you. It is faster to self refer. You can have zoom appointment which is easier if you want more opinions.
The next couple of months are a bit of a drag because you want resolution, but they can be important especiall if you provider wants you to be on ADT. Two months is supposed to be the best amt of time to take androgen deprivation therapy before radiation or surgery.
Keep posting back with new questions. This is a really good site.
Best luck.

I found that getting educated quickly on the facts of treatments and next steps was most helpful. Dr. Patrick Walsh’s book, “Guide to Surviving Prostate Cancer,” along with the online information at the Prostate Cancer Foundation (pcf.org) and Prostate Cancer Research Institute (pcri.org), provide you step by step recommendations and questions to ask. As importantly, you want to be treated by the best available doctors at prostate cancer centers of excellence, such as Mayo Clinic. A list of these is also available online. As recommended by others, after a biopsy and Decifer test, you will have better information to start asking the right questions. Also, know that even if your biopsy confirms prostate cancer, most cases of prostate cancer are curable. One step at a time and keep doing all of the healthy things that you have been doing, because they make any treatments much easier to recover from.

If your pirad score is 5, you most likely have cancer. However the biopsy will tell you your Gleason score which could be as low as 6 and just requiring active survalence. Also a PETscan will tell you if there is any spread. Good luck !

Thank you!!

Many thanks! This is some good information I hadn't thought of and I sure appreciate the guidance!!

Thanks for the information and reference material!! I will be looking into that book for sure.

Shep, it is never far from my mind but I am beyond the panic stage and I have rationalized that panic does not help but being mindful, reading, sharing notes here and other places, listening to my expert medical staff, following medical suggestions and instruction, helps me to cope and hopefully live a good life for longer

Wonderful and helpful comments.

shep247: my treatment experience was based on my research (including this web site) and my discussions with my doctors. After the urologist and discussions with 5 highly trained and experienced radiation oncologists, I narrowed my decision down to Proton or the Mridian narrow margin radiation machine. I chose the Mridian and would do it again if I had a biological reoccurrence. How much your healthy tissue is exposed impacts side effects. Many success stories on this web side with different choices but my 2 mm margins vs 3-5 mm with proton and other types of photon radiaton machines makes a difference and is worth asking for specifics from your radiation oncologists, including the built in MRI so the Dr can treat in real time not fused images. Quality of life was a big focus for me. I did not have Androgen therapy. My side effects were minimal with a little restriction with my urine. No pain or bleeding. I also had spaceoar inserted to separate the rectum from the prostate for less exposure.
There is a lot to absorb but keep coming back and ask questions and you WILL start to zero in on what you feel most comfortable with.