← Return to Three PSA tests in two months. 6, 7, 5.4. MRI indicates 1cm lesion.

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Not sure why this plan especially since you are at a top hospital like mayo. What good will a PSA test be in a few months when you are on ADT! Of course PSA is going to be low because of ADT so that's not much help! The next step is a Fusion guided biopsy. I would insist on a Transperineal biopsy, not rectal type, and no you don't need to be put out for this. Local anesthesia is fine.
Best of luck

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Replies to "Not sure why this plan especially since you are at a top hospital like mayo. What..."

@copyman The original poster was at Mayo and asked about biopsy. allex50 never mentioned where he is being treated but had a biopsy result of Gleason 9 or 8. In the US the next step would have been a PSMA PET before ADT.