First and foremost, I would take a deep breath and try to calm down. Faced with news like yours, the 1st and most natural response is to a) panic and b) think its critical to act immediately. There's no doubt this is serious and does need to be dealt with on many levels. Don't let fear drvie you to the first option presented to you, esp for something as radical as an
open surgery where the Uro wants to get in to slice and dice, removing everything, with no regard for even basic nerve sparing that may result in you having to wear a diaper or using other incontinence products or appliances for the rest of your life. And sex, after something like what your specialist is proposing, it may not be much of an option without considerable support-drugs, penile implant or vaccum assisted device. Think about
With scores like yours I would hope the results have been verifed by a top notch teaching University lab, preferably one doing clinical trials, as that type of setting can yield or confirm the Path findings because it deals with these types of findings for complex cases all the time. It would mean providing the actual specimens/slides for review directly. Think of it as a super duper 2nd opinion.
You post doesn't say how many other specialists you have seen on consult. Have you talked to a Radiation oncologist? At the least another Urologic Oncologist as a 2nd opinion? With values like that I am quite confident any self respecting Uro Oncologist would be able to fit you in sooner rather than later.
What is being proposed to you, an open surgical procedure, is very radical. Not saying its not the most appropriate but its still the most radical. Is there any consideration for robotic (aka Da Vinci) surgery as an option to try to minimize the damage that will be done compared against a human hand controlling the slicing? How many other opinions have you had that support this same approach?
Coming out the other end is the quality of life you want. open surgery is major and poses considerable risk not the least of which is bladder control and loss of sexual function. Are you prepared to deal with that? What about 3 or 6 mos from now?
In the end, what is the outcome data saying for men in your age range with your current Path findings re: survival rates? Has your specialist discussed that with you and provided you with his own stats for men in your comparable age range that he has performed open procedures on? How many of his patients are still around 1-3-5 yrs out from such a surgery? Have to had the chance to speak to one or two patients who had a similar surgery done that are in your age range to hear of their experiences post surgery?
This is a HUGE decision that will affect the rest of your life. An abundance of caution is needed, esp at this time when the natural tendency is to go in and remove it all as quickly as possible. That's not always the best option to take if its being done in panic mode. I hope for your sake you give yourself the time to become informed enough about the other options to
make the most informed decision you can. You aren't going to die tomorrow or next month from this type of cancer. Give yourself the time to get educated quickly using experts, plural, in your geographic area. In the end, its your life and you are the one that has to consent to whatever treatment option you ultimately end up taking.