Did you get an MRI with contrast. This allows them to target possible bad areas on the biopsies. If the MRI had a low pirad I would feel better about watching.
I had a pirad of 5 which indicated it was very likely I had significant PC. The biopsy showed 3/4 and I had the RP.
As far as determining whether to have radiation or radical prostatectomy I can not answer because it is personal choice. I have erectile dysfunction and incontinence issues but I had issues with pelvic pain prior to surgery. My goal currently is to try to manage the pelvic pain to a manageable level, it appears to be pudendal neuralgia. The pain is way beyond my tolerance level at times. I can manage my urinary frequency and stress incontinence with protection which I can live with if I can get the pelvic pain down which is stopping me from doing things with my grandchildren.