@capatov My case is somewhat similar to yours, except more advanced. (5 cores out of 12, seminal vesicles are now also involved). If you had chosen to put your biopsy off for another year, perhaps you'd be in my boat.

I was so concerned early on to avoid a biopsy in case it wasn't necessary, but now that I've been sentenced to 2 years of ADT, and 5 weeks of EBRT, I see that having a biopsy seems trivial.

Urologists seem a bit trigger happy when recommending a biopsy, but they have a very good idea of how serious things can get if you don't find out what's happening in time.

Part of my hesitation was the older idea, that was somewhat set in stone in 2012 by the US Preventative Services Task Force, that no men should be routinely screened with PSA testing. The problem then was way too many men were being tortured with biopsies and treatments with not much to show for it in terms of extended life span for the group. The solution, no testing, is now very clearly seen to have been mistaken. The current emphasis on active surveillance for lower grade cancers that are found on biopsy seems to be a far better idea.

It took me a while to actually look into this impression that I had, i.e. PSA tests shouldn't even be done, to where I realized things had changed since 2012. I did get a repeat PSA test to make sure the results were consistent, then I agreed to a biopsy - months after when I should have had one.

I had a transperineal biopsy in order to reduce the risk of infection that can happen more often with the alternative, i.e. transrectal biopsy. I felt the effects for weeks afterward, but the effects were hardly problematic. There were dark blood stains left by my ejaculate for months afterward but this eventually went away.