Second and third opinion on biopsy results

Hi everyone - Just wanted to give an update on our situation here. My husband is seeing Dr. Carroll at UCSF. On his biopsy report, they found perineural invasion as well as a very small component of tertiary Gleason 4 (primary/secondary was 3+3). Dr Carroll had the top molecular geneticist at UCSF review these results as well and came to the same conclusion. A question was posed to me earlier on the board how they were able to pinpoint this on a biopsy. The answer is that there were nerve fibers found in the biopsy samples that contained cancer, which means the cancer is traveling along the nerves. Apparently pCa cells like to hang around the nerves as it is their favorite "door" to exit. He is now scheduled to see Dr. Ahlering at UCI for a consult on Friday. He uses a new approach called hypothermic cooling (or something like that), which basically means he cools down the prostate gland prior to DaVinci surgery which is supposed to help protect the nerve bundles that are necessary for potency and continence. Dr Carroll initially thought my husband could go the route of AS, but with these findings confirmed he is suggesting RP.

Feeling a bit more concerned about this whole thing. All along I've felt like he will be perfectly fine and it's a hell of a hump but he'll get through it. Now...I worry :(

45 y/o
PSA 4.92
Free PSA (calc) 6.91%
2 of 12 samples positive
One is 33% of sample with G6 sum (PNI present)
Other is 8% of sample with G6 sum
DRE normal
No symptoms

 IMO, and I am not a doctor nor an expert, with PNI confirmed AS is pretty much not a treatment option anymore. Dr. Ahlering at UCI has a very good reputation in this forum and several of our members have had RP done by him and I have seen nothing but positive comments.  I have heard although, that he no longer accepts insurance for payment.

Good luck to you and your husband

Terry