The only thing I would add, is to hopefully get the Decipher Test done on your core samples. This is a test that looks for molecular level signs of the degree of cancer you may have...the aggressiveness and likely outcome the longer you wait. I was not given that opportunity. After my radical prostatectomy, I began to read about the Decipher test here in this public forum. I asked my doctor what my results were since they were not posted to his group practice's patient portal? He said that the test wasn't done because my insurance declined to pay for it. This was strange because they pay for EVERYTHING, and knowing that without the data and earlier appropriate intervention, it could actually save them some money, I was surprised. So, I asked my doctor why he didn't tell me that the test was declined by insurance, and to tell me how much the test is "cash" out of pocket. I was upset that I was not given the opportunity to pay cash for it. Now, three months post-op, he said the Decipher test would be worthless because we know my final category or classification of cancer based on the surgical pathology report that a lot of microscopic detail and date reported. That said...
I wish I was you. You have a nice low score and PSA is fine. Active surveillance is fine for as long as your PSA remains below 4 ng/ml (upper end of normal reference range). You'll have decisions to make in the future if/when your PSA starts to elevate. It will start with another biopsy (12 core samples), with any new gradation of the type cancer cells the pathologist sees to create a new Gleason score.
I was less lucky - four years ago my family practice physician closed his practice without tell me and the rest of his patients. I was focused on my diabetes care, and went without finding a new Internist to get a PSA for four years. I had a 6.1 PSA, and with a 12-core biopsy, was rated Gleason 3+4 = 7 with only 10% of cells being "4". So, I had the surgery, and the pathology report was more ominous with Extraprostatisc Extension (EPE), surgical margins, cribriform glands present, and lower level invasion into my left seminal vesicle. So, I am now a pT3b category with a nearly-certain likelihood of the cancer recurring in the first 5 years. My PSA from this week (3-months post-op) was great at < 0.1 ng/ml (basically "zero"). I will have PSA testing every three months for the first year, then every six months in subsequent years as long as the PSA remains at < 0.1 ng/ml. The moment it starts to elevate, I will start the 40-days straight of daily radiation. This changes your life...it will be on my mind every single day, and to a greater degree every three months (to start) wondering what my "next" PSA level will be, all while knowing my pT3b category is a near certainty for cancer recurrence. But at the same time, my doctor has repeated that I will be alive..."be here"...well beyond the next 14 years when my son turns 40 years old. That is my goal...to see my son turn 40, daughter turn 45, and granddaughter graduate high school and start (finish?) college. "Fingers crossed."
Your fear of salvage radiation “ Changing your life” Is really way more emphasis than is actually needed. 3 1/2 years after surgery, I had salvage radiation, It didn’t change anything in my life, other than allowing me to live longer. Only lasted 2 1/2 years Before it came back again, but I was undetectable for those 2 1/2 years. Since then, I’ve been on Lupron and Zytiga for 2.5 years and Orgovyx and Nubeqa For the last two years.
I had seven weeks of salvage radiation, I went to work every day right after it never stopped me from doing anything. Only drawback is, I’ve started having a little bit of incontinence after five years.
I even have BRCA2 but I’m still around after 15 years.