I am also 76 yrs old like you but except for my PCa diagnosis, am in quite good health. What has caught my eye in my pathology report was the finding of "perineural invasion present" just like your report. My gland has 3 lesions 2 of which are GL 6 and the third is a GL7. The GL7 tissue was sent out for a Decipher test which resulted in a Low Risk score of 0.37. Just had a second opinion with a medical oncologist at Medstar Georgetown Hospital who advised me to not worry about things since I was in his opinion Low Risk and should only consider Active Surveillance (AS). However, after reading all about perineural invasion (PNI), it was a big wakeup call for me. About 31% of those with PCa have PNI. To learn more on PNI and how it can influence your treatment go to these 2 articles: https://www.healthline.com/health/prostate-cancer/perineural-invasion-prostate-cancer AND also this one https://malecare.org/perineural-invasion-on-prostate-biopsy-does-it-mean-that-i-have-advanced-prostate-cancer/ . The second one looks dated as of 1998 but there may be newer info you can find on the internet. In summary, I intend to put AS on the back burner until I find out more about where PNI is located in my prostate (ie has it penetrated a nerve OR is tracking along side of it).To answer this I plan on writing a letter to the pathologist since she was the one who found the PNI. The main thing is to NOT allow the cancer to get outside of the prostate. What are your thoughts?