I am very similar , a bit further along in the journey in that I was diagnosed at 62 Gleason 6, genomic testing not aggressive. I did active surveillance for 3 years. Psa went up and down and I had three biopsies including the first that confirmed pc. PSA 4.5 at first and 8.2 just before I was confirmed to intermediate pc at age 65. 2 MRI's during the active surveillance period. The first showed not much change. The second showed a lesion and a targeted biopsy produced 3+4=7 Gleason. After consulting with surgeons and radiologists and an oncologist I elected surgery being that they all recommended some sort of treatment with gleason 7. If you research Dr. Scholtz PCRI he often says active surveillance even at gleason 7 but I did not want to chance spread outside the prostate and I was being told that chances were good it was still contained within the gland. I had prostatectomy done at Brigham and Women's in Boston 10/1/21 and just recently my psa was still undetectable. Consequences or new life post prostatectomy is another story which I won't get into here but everyone has their own experiences with the treatments as you will read across the board here on Mayo Connect.
Best wishes to you,
BFG1

@wsartor, what are the criteria for you and your team to move from active surveillance to surgery?