Hmmm, OK. Well, I think that most URO's like to do DRE's and RP's. It seems to be in their nature. I had every offer of radiation, seeding, removal, and Active Surveillance. When you say your Gleason is 3+3(6) and a Decipher of 51 percent...that sounds a little off to me. Do you mean the Decipher was .51 percent. You need to get a physical copy of your Decipher report from the URO and look at it and tell us what the Genomic Risk is and what the 5,10,15 year risks are. What is your PSA?

Now, first it sounds like you had a trans-rectal biopsy which has a difficult time getting all the prostate sampled. A transperineal biopsy could sample the entire prostate from 18 to 30 cores and then you really would know what you have and where. You did not mention if you have any tumors and the size, that will take a MRI and frankly, IMO, a MRI should have been done prior to a biopsy.

If you have two cores positive, no tumors, Genomic Low Risk, you could probably do Active Surveillance for a number of years. However, if you do that, then you need to test PSA every 6 months and MRI every 9 to 12 months. Don't let doctors lull you into yearly PSA and MRI every two years. The problem with AS is that at some unknown time, the cancer can jump start itself and spread. Something you absolutely do not want.

You likely have more options than you know, and, if you can give the members here more information they can better help you. If you had only one small tumor you could do NanoKnife, a transperinal approach that leaves the sexual and urinary function virtually untouched. There is HIFU, a trans-rectal approach, there is TULSA, a trans-urethreal approach. But, until you have an MRI with contrast you are at a disadvantage deciding what is the best approach. And honestly, if you can find a doctor that does a transperineal biopsy, I would get one of those. They are painless afterwards, almost zero chance of infection, and you get a full sampling of the prostate.