With a 12.9 PSA, you should be concerned, but…with a great surgeon having done a couple thousand DaVinci Robotic-Assisted RP surgeries, in a well known, highly regarded medical center of 400 beds or greater, you should be fine.
The key is finding an outstanding urologist, and having a bit of luck.
You will get your Gleason score from the biopsy, but it is only the cursory, “tip of the iceberg” information. It doesn’t really tell you anything, so make sure your urologist orders the “Decipher test.” That is a test for 23 prostate cancer-specific genes and mutations that offer a risk assessment score for how bad your cancer is, and offers an estimate of your longevity. You won’t know your fate until you get your surgical pathology report that tells you “everything.”
I had a borderline Gleason score of 3+4=7 with only 10% of cells being the grade “4”. I was mostly “3” level cells with a tumor that took up 30-40% of my prostate per the 12 core samples taken (three negative, three 3+3=6, and six as 3+4=7 with only 6-10% “4” cells). My overly confident urologist changed his tune when my surgical pathology report yielded EPE, surgical margins, left seminal vesicle invasion, and Cribriform glands, all pretty ominous stuff. My urologist then said: “Gee…it seems your cancer was a fairly aggressive cancer…we need to talk about radiation next visit”. What?!?!
It all starts with a VERY experienced urologist. Travel to the next town or wherever there is a ~400 bed hospital, hopefully a teaching institution hospital, to find the highest level of competence and experience. Make sure they have the DaVinci Robotic RP machine. Your life depends on it.