Doc just recommended treatment options, head is spinning! Thoughts?

Hi there! Brand new here after meeting with my urologist today.
My basic story:
57 yo white male, good health, no health problems except slightly elevated BP and HDL numbers
Elevated PSA for years (4.x range) with no action
Referred to urologist 2024 with PSA = 4.741
First biopsy Nov 2024, two sections showed 3+3 and 3+3
Active surveillance, supplements, etc.
Next PSA April 2025 = 4.968
Second biopsy Dec 2025, two sections showed 3+3 and 3+4
Followup on results was today 1/6/26
With the jump in the 2nd sample's number, doc recommends treatment
He laid out surgery, radiation, and HIFU as options (he is a licensed HIFU provider so emphasized that one).

My head is spinning with the side effects of surgery and radiation, but HIFU is out of my price range. At only 57 and happily married I'm struggling with impotence/incontinence potentialities (better than the alternative, of course, but...)

Thoughts from this group?