With your PSA of just 2.05, what prompted you for any additional testing?

With a 6(3+3), I first would look for reasons whether to choose (or not choose) active surveillance.
What was your?:
> PSA: you indicated yours was 2.05
> PSA Doubling Time
> % Free PSA
> PSA density
> PIRADS score (from the MRI)
> Genomic (biomarker) test results: you indicated your Decipher was mid-range
> Genetic (germline) test results
> SUVmax scores from the PSMA PET scan

What did they mean by “…suggested more extensive cancer that may be in an adjacent lymph node.” (With just a 3+3, you don’t appear to have any extensive cancer in the first place.)

If it were me (with numbers as low as yours, I would choose Door #3) do nothing for three months —> and then do a repeat PSA test, and a % Free PSA test, check my PSA Doubling Time and PSA Density, get a Genetic (germline) test, and perhaps a different genomic (biomarker) test on the existing biopsy tissue.

If it were me, I would not get anything more invasive than bloodwork done; what’s the rush?