That's a tough one...with a GS 3+3, you would normally continue to actively monitor.

The rising PSA is the question along with the confirmed spots in your imaging and DRE.

You have options:
surgery
either internal or external radiation to the prostate
radiation and add short term ADT, six months. That may address any micro-metastatic disease that may have escaped the prostate.
continue to actively monitor.

One thing to do is calculate your PSA doubling time, MSKCC has a online calculator - https://www.mskcc.org/nomograms/prostate/psa_doubling_time. This will give you an additional piece of clinical data

General rule of thumb is if PSADT:
> 12 months continue to actively monitor
6-12 months the grey zone, consider treatment
<6 months time to treat

DO some more homework and look at three things:

Doublet therapy - here's one link to get started - https://www.urologytimes.com/view/the-role-of-doublet-and-triplet-therapies-in-prostate-cancer
NCCN Guidelines for patients - https://www.nccn.org/patientresources/patient-resources/guidelines-for-patients/guidelines-for-patients-details?patientGuidelineId=49

Kevin