JDH697, It is a personal decision you have to make on being told to actively monitor or treat.

I did a lot of research and then got two different consultation and opinions.

Mine was 3+4=7 and listed as intermediate risk so the radiation treatment would normally include hormone treatment as well. However my Mayo oncologist/radiologist recommended Decipher test. The Decipher test showed that I was low risk not intermediate and thus hormone treatments not needed.

It was good that your urologist mentioned the second opinion on biopsy. But the Decipher test is a genetic test to determine risk levels and can really make a difference in treatments. Also the PSMA and bone scans are important as they determine if cancer is inside prostrate or has spread.

With your PSA number and Gleason score I would definitely explore the second opinion on the option you were given to actively monitor. This options with my Gleason score of 3+4=7 was never given as is intermediate risk.

I personally did not want the stress of active cancer in my prostrate and would have chosen radiation treatment (proton) even if given option of actively monitoring. I am glad that neither oncologist/radiologist, and urologist listed it as an option.

I also had PSMA and bone scan all negative. I had 30 rounds of proton pencil radiation and finished in July 2023. I am now in the PSA monitoring and first one dropped from prior to treatment 3.75 to 1.2. I was told it may take 1-2 years for PSA go reach it's lowest base. The main objective if is rises during the monitoring every 3 months. My next one is in December. Had little side affects and none now.