Every individual case is different, I am 68 & opted for ralp surgery which wasn’t to bad.
Incontinence was only a minor problem for a week or so, but ED was more of a problem at my age but slowly getting there.
Regarding active surveillance, don’t forget even after surgery you still have the anxiety of psa tests every 3 months “looking for re occurrence” for the first 12 months, & then at longer gaps for the following years.
In your case, you could have act surveillance for the next number of years & still be fit enough for surgery at a later date, if ever.
My main concern was that I didn’t want the continual biopsy follow ups that was inferred that I may have to have, & I felt that I was fit enough at that time for surgery but who knows how fit I will be in say 5 years.
Everyones circumstances are different.
All the best. Jeff.