Sounds like you've figured it out.
When I read it on my path report, just the sound of it made my knees buckle...literally. I thought I was going to get sick because I figured it meant it had spread. But that's not the case. It's near irrelevant in your diagnosis. Thought used to be that if it was in the nerve sheath it could travel outside the prostate faster through that path. But the biopsies pick it up passing through a nerve inside the prostate, and it does not mean that it has spread. Many path reports no longer include it. Lucky us that ours did and gave us yet another worry!
If your PSA is relatively low, which it is...mine was 4.65, and your gleason is 6, that is what they will use to determine the chances of progression and extraprostatic extension. At the end of the day, it's all statistics anyway and all the options for treatment exist for you. Choose what you are most comfortable with. And it sounds like you are already doing your research which is great.
Good luck in your treatment decisions.
42 yo. now
5/07 PSA 4.65 at routine physical
6/07 biopsy positive for cancer...Gleason 3+4...diagnosed at 41 y.o.
6/07-9/07 manic research and interviews with physicians across the country in search of the "right" decision. I went to Mass General in Boston, Loma Linda, University of Chicago and Northwestern.
9/17/07 - Radical Retropubic Prostatectomy Surgery at Northwestern Memorial in Chicago by Dr. William Catalona. Thankful the father of the PSA test was right here in Chicago.
Post op pathology was Gleason 3+4 with negative margins, no seminal vesicale involvement, no lymphatic or vascular invasion, bladder and urethral free and tumor volume was 5% of 27.3g.
9/27/07 - Catheter removal...let the games begin...
12/07 - Threw out the pads. I only had to use 1 pad per day for protection against minor drips.
I started Trimix 8 weeks after surgery with success.
I hope someday I won't need injections, but I hope more that my PSA stays at 0 forever.