@kyndats
Glad to see that Gleason of 3+3=6. I would explore what gene(s) you have that cause the higher Risk category and Decipher Test score of 0.78. Like many people, you may have an inherited genetic marker(s) that predispose you to greater challenges in acquiring and/or treating one or more types of cancer. The Decipher Test again, is prostate specific: 22 prostate-specific gene identifiers that stratify your risk against others. Once you find out which gene(s) you have, you can search on them to learn more about them, and thus be more informed when you discuss it with your urologist to set a plan. I am curious...
How did this diagnosis come about? It seems that it might have been a random thing...like an annual physical that included a PSA. The 4.87 ng/ml PSA prompted your physician to refer you to a urologist who did the biopsy, etc. That is actually the way most men "find out"...a PSA and digital rectal exam (DRE). It is up to your physician and you, but active surveillance seems like it would be the route that you go. If the gene(s) involved in the higher-than-expected Decipher test are such that they cause an aggressive or difficult to treat form of prostate cancer, then your urologist will know what to do. My only additional recommendation and wish for you, is to find THE BEST urologist you can find. Determine the travel radius or distance your are willing to go to find the best, university medical center-based urologist you can find...a place where lots of men are seen and where cutting edge treatment and surgery occurs. If you are in a small town, perhaps rural America, I would hope that you find it in yourself to make the trek to a bigger city to find that university-based physician and medical center. Even in the middle of sprawling suburbia like I live in, and going to the biggest, local medical center you can, doesn't always guarantee that you are seeing the best urologist around.