Decipher is not the only biomarker (genomic) test available to provide pre-treatment information. There are many different biomarker tests, depending on what you’re looking for:

> FoundationOne®Liquid CDx; Guardant360; Caris Assure.
> Decipher; Prolaris; OncotypeDx.

Liquid biomarker tests:
> (blood): 4KScore; EpiSwitch PSE; Phi Prostate Health Index;
> (urine): SelectMDx; PCa3 (PC Antigen 3); MyProstateScore (MPS), ExoDx.

(I’ve probably missed others.)

So, it depends on what biomarker information you’re looking for. (I had the OncotypeDx and Prolaris tests; never had a Decipher test.)
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At 65y (about 5 years ago), I had radiation first for a 3+4=7 (upgraded to a 4+3=7 immediately prior to treatment, for which I simply added 6 months of ADT) for a number of reasons, one being that should I have a recurrence, I would have more salvage options available.

“Getting the cancer out” provides no statistically significant benefit for success than doing radiation.

My thoughts went the other direction —> I couldn’t imagine starting with surgery as first course for treatment for me at age 65y in otherwise good health, initially with 3+4=7 contained Pc. (Why have surgery first and then (in case they didn’t get it all or if there was recurrence) to have do radiation also? Why not do radiation first, and then if there is a recurrence have the options of cryo, brachy, or SBRT (because they’re all very targetable), or possibly even re-radiation in some cases.)

The idea that “if you choose radiation first, you cannot have surgery later” has some historical truth to it, but is old-school thinking and doesn’t consider modern treatment techniques.

Lifelong hormone therapy isn’t really a treatment option (though, some choose that form of palliative care for some reason).