What other information was given with the biopsy to indicate risk?
Did they give the % of 4 (55% 3 and 45% 4 worse than 90% 3, 10% 4 but both 3+4). Sounds like this a fusion biopsy where all 3 cancer cores were from the target and the random samples were benign? Decipher score will help.
Doctors tend to recommend what they know so expect urologists to favor surgery and radiation oncologists favor radiation with age 60-75. Could also look at a focal treatment even though these have higher reoccurrence rates since that will not preclude RP or radiation later.