Jerdeb- this profile is similar to mine . yoru 3+4 Gleason is solid . No 5 Gleason which is very good ! I like also no invasions or extensions and Lymph are all negative . IF it were me , I would push for a PSMA PET scan, and a few more PSA's for data points and velocity checks while waiting . Also , start researching who the best RO in your area is . I would want a consult with him asap. Dont let your URO pick him , as around and see who is considered the "best". Funny/odd how "merit" is always front and centre with Dr's yet DEI is ok for other jobs ? I know , as I am a pilot and we are getting some very strange hires as 1st officers -wow! . But I digress. I think once you consult with a radiation oncologist and have another appointment with your urologist, things will come in into picture. Let us know what he says about the PSMAPET scan. I would be pushing for that. Overall, your PSA number is fairly low, but you would get a good image on the scanner. What part of the country do you live in? I gather you live in the USA? Things are a little bit different here in Canada however, the care is quality. Each hospital here is kind of different. Some are on the ball and some are mixed up and understaffed. It depends who the managers are in the hospital. So take the recommendation of your urologist, but start your research on who the best RO in your area . Keep us in the loop . Your pathology isn't that bad actually , very similar to mine . I am 3+4 as well. About a year after the operation, my PSA never zeroed out so at 0.14 I consulted with a radiation oncologist Inn Victoria. He said the PSA is rising slightly over the last year, so there may be some healthy or cancerous cells left behind probably close to the bladder in the pelvic region. He said I could wait a year and a half and have external beam radiation at that time and he hypothesize that my PSA would be around 0.4 at that point. He said we could attack it early with 22 sessions and no ADT right now and that alternative would probably be more fruitful. Two years ago I did the 22 sessions. Now my PSA has been falling off. Last PSA was 0.041 . quit a bit down from 0.14 in reality . I will continue my prayers for you and provide you my best advice, not being a doctor, but having experienced what you may go through. Ask a lot of questions of your urologist. Prepare your notes and folder ahead of time. Dont worry too much .... keep active ! James on Vancouver Island.