@dgd1953, can you expand on your situation? like your GL # and MRI findings and biopsy #'s. I had Intermediate favorable #'s (3+4, PI-RADS 2, 1/12 cores positive, low PSA. But high decipher. everyone wanted me to do something whole gland,.......... Radiation (many types) plus Hormone TH. OR RARP. .......

I was just trying to get a risk assessment of partial gland therapies. HIFU, TULSA-Pro, MPP, with a High decipher score

I was put on Active surveillance earlier this year. The urologist at first was dismissive about my elevated psa, thinking it was likely due to inflammation. He said to get the psa tested again in a few months. I did and psa was the same level about 4.2.
I asked if i could have an MRI, he agreed. It showed a lesion likely to be cancer. A biopsy was then done with 4 cores 3+3 and one core 3+4.
He suggested Active Surveillance for quality of life. He said a study was done at the John Hopkins instititue of 1800 men on actice Surveillance for an average of 15 years. Only 4 of the men died of prostate cancer, while 48 percent eventually underwent treatment and 52 percent remained on A.S. He then recommended a Decipher test as I was about to leave. The Decipher turned out to be high risk. on the follow up visit he then recommended surgery.
I told him i wanted to wait another 6 months to a year and have another MRI and biopsy. He then got a little angry and combative and asked me what was the point of me coming to see him at all, as if i was wasting his time. I told him I was hopeful that my cancer would regress due to going all out on healthy lifestyle choices and would like to wait for another MRI and biopsy. This goes along with quality of life in my view.
He asked me why I originally even wanted a psa test and the subsequent mri and biopsy. Isn't it normal for me to want to monitor my condition and progress? Do some urologists use the decipher as a tactic to get more surgeries scheduled? Kind of a bait and switch like tactic.
First dismissing any cancer likelihood, and then it's urgent to operate?
I realize some may feel the need to argue this as another conspiracy theory, but others might feel the same apprehension as me. As a side note, when i got to the consult today, the nurse said the doctor wanted to perform a cystoscopy on me. I said I did not know anything about that but she said the doctor wanted it. She then filled me with lydocain. She came back a couple minutes later and said she gave it to the wrong patient.