@toeknee
You can’t get more aggressive than Gleason 10 unless there are other things found in the biopsy.

Were any of these things found in the biopsy intraductal, cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer more aggressive.

Have you had a PSMA PET scan yet? Your mentioning that pelvic lymph nodes are suspicious may be because they are lit up a little bit in the scan. Did they give you an SUV value for the pelvic lymph nodes?

Have they been talking about doing radiation? You might be a good case where they do multiple sessions of IMRT followed by brachytherapy. That can really knock down the cancer, Even more than surgery. Find a doctor that does brachytherapy So you can get an opinion about it.