Follow up meeting went as well as can be expected. I appreciate all of the advice given as it helped me put together a logical, intelligent series of questions. Most of those were answered by the doctor before they were even asked. My final diagnosis was "Unfavorable- intermediate risk -Gleason (4+3). Based on the Cribriform patterns and the fact that 80-90% of each core within the lesion came back at a 4, the doctors did not suggest active surveillance as an option. We talked about some of the latest focal treatments, surgery and radiation. After a lot of discussion and research with my wife ( she is a nurse and an amazing partner) we have decide to go forward with surgery at Mayo Rochester at the end of July. Everyone has to make the decision based on their own circumstances but for us the best chance of removing the cancer and still being able to treat any possible recurrence was surgery. At 57 my priority was whatever gave me the best chance to enjoy watching my grandkids grow up. If this means that I have to deal with some incontinence and as a couple we have to deal with ED, we are ok with that.