Hey caryg1955 and others - Sounds like I am in a similar place as you and others. After having a partial nephrectomy in July at Cleveland Clinic in Ohio, I had an mpMRI after having a slow but consistent rise in my PSA from 1 to 5 over seven years. With the MRI revealing a .6 cm PI-RADS 4 lesion, I then had a transperineal fusion biopsy revealing four of nine positive cores (two at 5%, one at 15% and one at 35%) and all at Gleason score 3 = 3 =6 Grade Group 1. I then opted for the Decipher test given family history of aggressive prostate cancer and got the results a few days ago showing a high risk at .78. Will be circling back with my surgical oncologist although I suspect he will recommend surgery given the high Decipher score. Although I have great confidence in my surgeon, I will at least consider consulting with a radiation oncologist for a second opinion and will push for PSMA and bone scans to rule out spreading.
Would greatly appreciate hearing about the decision you made and from others who might have thoughts or comments.
All the best to you.