@hirejohn, Although you indicate you have a family history of prostate (and maybe especially so) you may want to consider getting a germline PCa genetic test, besides obtaining your Decipher Score.

You can get germline genetic testing for free by registering for the Promise study at the link below. Besides receiving the test results, you can speak with a genetic counselor who will explain them. https://www.prostatecancerpromise.org/about/

Also make sure you get a copy of your Decipher GRID report; which includes a lot of additional information (including a Clinical-Genomic Risk Model assessment), based on the PCa tumor cells taken from your biopsy.

Based on a mpMRI fusion biopsy, my 3+4=7 Gleason (with low volume pattern 4) was classified as "Low Risk" for metastasis, due to my 0.22 Decipher score. This along with the finding I had no genetic variants (mutations) for prostate cancer (based on my Promise study results) allowed me to confidently pursue active surveillance.

13 months after being diagnosed, and tripling my running program (upto ~35 miles/month) and losing 25 lbs, my 12 month follow-up mpMRI showed signs of lesion regression, as compared to my initial mpMRI and my post-biopsy PSA's have stabilized 20% below my pre-biopsy level.

I went to my urologist this morning and he indicates, based on all my data, I can delay another biopsy, since no sign of PCa progression is evident.

My vigorous exercise/modified diet approach has not been easy AND it's no guarantee to be successful for similarly diagnosed men; however, I like to share my story as an encouragement to those initially diagnosed with a similar situation as mine.

There is a viable alternative (I have not even discussed all the beneficial side-effects I've experienced) to immediate treatment, for men diagnosed with low risk PCa...but IMHO it requires implementation of a significant lifestyle change. Some men may not be able (or simply don't want) to adopt such changes...I understand...and to each their own.......

All the best with your results and decisions!