@tmestanas91
Did your scans show no metastasic disease? That is good news. It also sounds like you know about other tests like the PSMA. The bone scan is looking at bones (I had that also) and the PSMA is looking body wise for the prostate cancer protein. I had that also (negative).

For me and we can only give you advise in our own experience and what we did. I don't see you mentioning Decipher. The Decipher is a genetic test that will help define your risk level. That will have a lot to do with your options for treatments. If me I would asked for the Decipher along with the PSMA. That gives you a wide range of tests then discuss treatment options.

What you are going to read on MCC is posters saying their urologist favor surgery and R/O favor radiation. My urologist at Mayo sent me to consultation with Mayo R/O. It was my Mayo R/Os that ordered the Decipher, bone scan, and my R/O at UFHPTI ordered the PSMA then UFHPTI discussed their recommendation with me based on all the test done. And that was proton radiation and because my Decipher came back low risk no hormone treatments even though my biopsies said intermediate.

Those that had surgery and reason why can better comment on surgery. Those who went on hormone treatments can also comment better than I on that treatment also. I can comment on radiation and there are many forms of it and treatments. Some are very new. I can send you a recent WEB MD on latest prostate treatments but is so long would suggest doing it on private message. Let me know if you would like me to copy that and post on a private message.
Good luck on your journey with this.