@chocchip Some prostate cancers don't create much of a PSA rise. This case may be like that and thus it was a very good thing that a DRE was performed. The Decipher score of 0.35 is a good sign but it's fairly close to the upper limit of low risk which is 0.44. As others have said, it is way better to treat a cancer at 3+4 rather than at higher scores with more cancer volume involved. It's not a cut and dry decision at all, but if it was me, I would go ahead and treat it.