Don't listen to us. We each represent a series of n=1, and are amateur researchers. Go to the cancer center of excellence of your choice and speak with 1 or more doctors there. They spend their entire professional lives reading, thinking, and talking about this. Take your partner with you. Then listen to your heart and your partner. Even if insurance doesn't cover the visit, it's worth the out of pocket cost.

FWIW, I'm 74 with a similar biopsy and PSA profile to you. I chose surgery and 7 months later am feeling 100% positive about it, with undetectable PSA, return of continence, and successful sexual function with viagra and a loving wife. YMMV.