HI,
Let me share my experience, which may have no bearing on your decision process. At 47 I had a PSA of 7, which suggested surveillance. By the next year it rose to 9 (rule of thumb is PSA should not be higher than the 1st digit of your age). And I was only 48 so an unreasonable reading would have been 4 to 6. Thus began biopsies every 6 months which were negative. By the time I was 50 the biopsies were every 3 months and my PSA was now 14. The last biopsy was positive in one sample, so I went ahead with the RPA surgery. The work-up included full body scan before the surgery. The cancer was contained within the gland and no lymph nodes were positive.
I am now 75 and PSA still below below .1. Looking back, by the time I was scheduled for the last biopsy I was feeling like a hunted animal, and told my wife that I wasn’t going to have any more biopsies. I insisted that the doctor was a hunter and I was the game.
Some things to consider: 1) Any history of urinary infection? This can affect PSA readings. 2) Do you hard exercise on a bike which can also aggravate the prostate gland? 3) Do you have a genetic history where a parent or grandparent had known prostate cancer? In my case all my relatives Dad and uncle were diagnosed with elevated PSA, but died from other causes.
Deciding which coarse of treatment is difficult due to provider bias. If the urologist is a surgeon, then surgery is the recommendation and if they are not then radiation may be the recommendation. Remember my data points were in 1995 and I suspect there have been improvements in treatment. Again, at the time of my treatment the post surgical problems of impotence and incontinence were the same after 2 years as far as the number reported. When it comes to treating cancer with an unknown rate of spread I believe that treatment should not be avoided. I can appreciate the roller coaster ride you are on as you face this very difficult decision. Best wishes, Keith

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