The question is what will a second opinion produce in choices? If the 2nd opinion is to undergo a PSMA PET, and, if done and it shows no positives outside the prostate, that might favor surgery, but I actually don't think your decision changes by much.

A positive PSMA PET would, I imagine, rule out radical surgery. If a negative PSMA PET? Note: I do not know the detection limit of PSMA PET, so a negative is a good thing but does not rule out spread beyond the prostate. You will still be stuck with choosing radiation or surgery. If surgery, then you are going for a "cure", because if the disease is confined to the prostate, if you cut it out and put it in a jar, you've likely got a cure. Having said that, I think going for a cure is a better choice for a younger man. At your age, they likely will recommend radiation. My situation (3 yrs older) is similar to you in age, health, PSA, and pathology. I chose radiation six months ago based on my estimate of side effects, quality or life, and the reality of actuarial tables.

That's one opinion. What do others think?