@mkanteck

I was 20 years younger than you at diagnosis (last year) and also had 3+4 with 30% pattern 4. I decided on surgery and we were planning for it about 4 months out (to give me a summer break beforehand) when I received my 0.86 Decipher score. Multiple doctors' advice was to schedule the surgery asap.

My 0.86 put me in the 95th percentile for genomic aggressiveness. Your 0.95 probably puts you in the top 1-2%, and not in a good way. If not treated, your cancer is going to progress and will eventually metastasize, it's a question of when, not if.

You potentially have a window to cure it right now, but the longer you wait, the greater the risk that you'll miss that window and will be playing whack-a-mole with the metastasized cancer for the remainder of your life.

It's your decision to make, and your care team are your best resource, but any doctor advising AS in your situation should be aggressively questioned as to why. Go for that second read of your biopsy, find an oncologist at a COE to speak with, and push for a PSMA PET scan to search for any signs of spread. Then make the decision you feel is best for yourself. Best of luck.