It really comes down to your personal risk profile. At what level do you feel that treatment is probably necessary, necessary or definitely necessary.

Personally, I would be happy to continue monitoring with your numbers. Others would not feel comfortable at all with that approach.

I watched my PSA go from 5.75 in 2016 to about 17 in late 2022. I had in my head a PSA number of 15 that I would definitely treat at. I foolishly didn't check my numbers for 12 months and they spiked from 12 to 17 over that time period. Did I leave it too late? Do not know but I was very pleased with my personal treatment outcome.

Certainly you should get a 2nd opinion. I presume you have spoken with a professional who isn't a surgeon.

It is a big decision but not one that should be constricted by time. Most prostate cancers are quite slow growing.

I wish you well.