I am assuming the 'he" in your second paragraph was Dr. Mark Scholz, not your urologist, but could be read either way.
Your personality apparently did not present it self fully to Dr Scholz. With your pr
opensity to worry, IMO you are not a cancidate for AS which would present 4 chances to worry every year possibly for many years.
So not a case that AS would not work with your metrics, it would but not with your psyche.
With G6 confirmed by Jonathan Epstein, regardless of %, you have ample time to continue to do your research and make an informed decision, be it surgery or brachy or something else.
Good luck, sounds like a good consult.
I agree with Dewayne
The only reason to go with surgery now without further research in next few months would be if you expected your 2015 insurance to be materially worse than your current insurance, but I think you said you were a financial advsor and probably have that covered (no pun intended).
With respect to potential damage to rectum and bladder, even though I am a patient of Scholz, Lam & Turner, I would believe the RO on discrete matters of radiaiton, I would believe the surgeon on discrete matters of surgery and I would believe the medical oncologist on general matters of surgery versus radiaiton.
This is the same advice Tall Allen gave Compiler to take Dr. King's opinion of SBRT over Dr. Lam's the MO or Dr. Kwon the urologist/surgeon.
The plus side of deferring a while is that come Dec 1, the guy I consider the best HW adviser Tall Allen will be back from his writing sabbatical.
66 - DX 64 2/13 PSA 3.68 (6 mo doubling) Gleason 9 (4+5)
T1CN0M1B stage IV w. 7 of 12 cores worst ones 70% right PNI
oligometastatic at Dx 5 tumors 1 right sacro, 2 on
T4 & T9, none visible on 5-21-14 whole bodyscan
1st Lupron 4 month 3-28-13,
PSA down was 3.68, Zytiga June 2014
PSA < 0.01, T < 6 on 10/14,
Prostate shrunk from 50.4 to 15.0
Provenge in Sept & SBRT Radiation in Oct
Post Edited (LupronJim) : 11/21/2014 3:41:14 PM (GMT-7)