I am 69 years old and was diagnosed with prostate cancer about 4 years ago. I have no family history of this disease. My PSA in 2020 was 6 and a biopsy showed I had a few cores with Gleason 6; no Gleason 7 or higher, so I went on active surveillance. Over the past 18 months my PSA jumped to 11 (Jan '24) and in July it is now 12 (as of July 2024). The latest MRI showed no additional growth in two lesions, however, the latest biopsy showed new Gleason 7 growth (3 + 4) in several cores with 4 being 5% to 10% in those cores. I had a PSMA Pet scan in June '24 that showed no metastasis. I have consulted with my Mayo urologist regarding the radical prostatectomy option and my Mayo radiation oncologist about proton radiation with possibility of ADT.