My advice - if you have prostate cancer...find the highest quality, most skilled and well-reviewed urologist to do a single-incision DaVinci Robotic Radical Prostatectomy. Like my doctor told me when I asked about "active surveillance": you"have" prostate cancer and it is not going away...there is no need to watch and wait for two years, it is only going to get worse, so...I am taking your prostate...now." That said...while every surgery has its recovery issues, I still do wonder if I should have waited: my father lived to 99 years 10 months "with" prostate cancer and no treatment. But, he suffered greatly with horrible UTI's and sepsis his last five years. His doctor said he was now too old for the surgery, with which I agreed. My maternal grandfather lived to 96 "with" prostate cancer. It was diagnosed in the late 1970's and he lived until 1992 - roughly 15 years without many issues. He dies of Alzheimer's. He went for a monthly injection right into the prostate (ouch). My maternal uncle lived to within weeks of his 87th birthday and died of a massive cerebral aneurysm/stroke. He had his prostate removed about 10-12 years prior. They each had their issues, but none of them had my issues.
I just had my 6-month check up - PSA still < 0.1 ng/ml. But with "surgical margins" and cancerous tissue left in me, plus my diagnostic category/grade as a pT3b, my cancer has a very high probability of returning within five years. Had I left it intact and just done other treatments, I would at least be 100% continent and able to perform sexually. While I have regained 98% urinary continence, I have not had one erection in 6 months which is extremely depressing. You haven't shared your Gleason Score, your Decipher Test score, or the descriptives in your biopsy report, but I can tell you this: the Gleason Score doesn't tell you anything until your prostate is removed and the surgical pathology report is given to you. THAT is the tell-all report. My overly confident "we caught it early" urologist (Gleason 3 + 4 = 7 with only 6-10% of cells at "4" - so very close to still being a Gleason 6), was dumbfounded when my surgical pathology report came back with lots of other issues that threw me into the pT3b category. Yes...the post-surgical complications are unpleasant, but I read here that a lot of men do not suffer them at all, or for less time (we're ALL different). I still say get the radical prostatectomy...then you know the cancer is gone ("if" there are no "surgical margins" in the pathology report, which means your urologist left cancerous tissue inside of you, like mine did, which only happens 10-20% of the time). Good luck.