50 GY and over are more likely to damage the urethera. ADT would sensitize the tumor cells to the radiation. Protocol with MRI guided SBRT is 40GY in five treatments. It sounds like you are in very good hands at UCSF. If you haven't had genetic testing for the tumor, that could add guidance. Most are using decipher. But, I think it is good to get second opinions satisfied or not. It is fairly easy with zoom and with the prevalence of Epic and its
access to your records. I can recommend Hoag, City of Hope Lennar, and UCLA for second opinions.
Best wishes

jarjlb2,
how is it that you find the best doctors? Kurtzman would be THE LD brachytherapy expert.
This treatment would be the most protective of surrounding tissue. Ask how close they you be to the nerve bundle? Ask about the long term BCR with ld brachytherapy.
Have you had the generic serum lab for cancer.
With as much information as you have given, I'd choose SBRT, but not at UCSF. I'd go for the MRidian Viewray. It will be interesting to see your PSMA. Could switch things up a little if it is even more definitive on the nerve bundle involvement.

You can search me under the Prostate Board. My boyfriend was treated at UCSF, by Dr. Peter Carroll with stellar results. Surgery August of last summer, 2023.