There are additional tests & calculations that help provide more information on the possible aggressiveness of the cancer:
> PSA Doubling Time – the number of months it takes for PSA to double. If the PSADT
is < 10 months, that’s a sign of possible aggressiveness. If it’s < 3 months, that’s serious.

> PSA Velocity – the change in PSA levels over time. A rapid rise in PSA may indicate
the presence of aggressive cancer.

> % Free PSA – PSA circulates in the blood in two forms – either attached to certain
blood proteins or unattached (“free”). If the PSA is high, but the % of Free PSA is low, it may be an indicator.

> Biomarker (genomic) test: Looks for genes, proteins, and tumor markers that tell
more about the prostate cancer. (Not the same as genetic testing.) These tests
include Decipher, Prolaris, OncotypeDX, and more.

> Genetic (germline & somatic) test:
—> Germline: Tells you which genes have been inherited by your parents. (Also, not only for other males in the family, but have the female relatives been tested for the same gene mutations related to breast cancer? They say that either gender can pass the gene mutations to the other.
—> Somatic: Tells you which genes you have acquired (mutated variants) caused by
cell mutations or environmental factors.

—> Additional Bone/CT/PSMA PET scans results.

With this additional information, along with the PSA, PIRADS, and Gleason, you’ll have a full picture of the status of his disease.

(Also, look in the MRI and biopsy results to see if the phrases cribriform pattern, extracapsular extension, seminal vesicle invasion, perineural invasion or intraductal carcinoma mentioned? If not, that’s good. Those are often indicators of more aggressive cancer.)