Jim, Welcome to our club.
You have gotten good advice above, there is no need to rush. With your biopsy showing 1 core, G6, low volume (10%) you have plenty of time to make a decision. And it would seem that you are a perfect candidate for AS, assuming you are comfortable with it. If you go that route make sure you are in a structured program with prescribed timelines for regular PSA tests, a schedule for when and under what circumstances you will have another biopsy, and prescribed circumstances under which you will agree with your medical team that treatment is required.
Getting a second opinion from Dr Epstein is a very good idea, and if i were you (wait, i WAS you) i would make sure to do that. As mentioned above, a very small number of men find that on second opinion, at the very least,its debatable thatthe biopsy slides contain cancer at all. But dont count on that.
Keep in mind, on the other hand that 1. its possible that you could get upgraded to a higher Gleason score on second opinion, and 2. in a small number of cases, when the entire prostate is looked at after surgery, an upgrade to a higher Gleason score takes place. This can happen in 20-30% of cases, from what I've read.
i'm a surgery guy, i had all but made up my mind, like you, from the moment i was diagnosed, that i "wanted it out". The guys here pushed me, as they are pushing you, to get opinions from other disciplines, and i did so. I went with surgery anyway, and I'm glad i did. But i am also glad that i explored ALL of my options before making a final decision, because it made me much more confident going in that i was doing the right thing, for ME.
Prostate Cancer is big business, surgeons want to cut, radiation oncologists want to burn. And it is different from many other cancers in that there are a number of primary treatments that will have an equally high chance of producing a good outcome, especially with biopsy results like yours. So its up to us/you, to get educated and be your own advocate.
Goood luck. And lean on the group here, there is a ton of knowledge and support
Dx Age 64 Nov 2014, 4.3
BX 3 of 12 cores positive original pathologyG6, G6, G8 (3+5)
downgraded to 3+3=6 by Dr Epstein, JH
RALP with Dr Ash Tewari Jan 6, 2015
Post surgical pathology – G7 (3+4), ECE, Margins, LN, SV all negative
PSA @ 6 weeks 2/15, .<02, 4/15 <.02 7/15 <.02, 10/15 0.00 (new lab)
My Story: tinyurl.com/oo9x4aq