David,
I'm arriving a bit late to this thread and may have missed what's already covered. I found my diagnosis to be hopelessly vague, despite half a dozen second opinions.. 71 Year old man with NCCN unfavorable intermediate risk prostate adenocarcinoma -- T1c (T3a based on MRI) M0N0 ISUP Group Grade 3 (Gleason score 4+3; 4/14 systematic cores); initial PSA of 4.08 ng/mL; Decipher 0.57 intermediate.

After a great deal of discussion and research, I completed tri-modal: Orgovyx/4 months; 2x Cyberknife boost; 23x IMRT and now, thankfully, am in "remission".

When I first questioned the diagnosis and ADT in particular, I was told that I had 'risk factors' that 'may make me high risk'...OR not. That led me to complete a PET SCAN and Decipher Grid, which you may have done already, but, are great since they are easy and non-invasive.

I completed treatments in Jan. of this year and, again thankfully, have very few side effects. However, my T has not returned to normal, it's about 50% of previous, and that has associated: belly fat, slightly less strength, moderate ED. Given the information that was available to me, I'd make the same choice, but, would have certainly preferred to have enough valid data to avoid ADT.