Batsam10, I was about 5 years younger than you when I was first diagnosed with Gleason Score 7 (4+3) prostate cancer in 2022. I did all the research and ultimately decided on a robotic prostatectomy at a center of excellence (Mayo-Rochester, MN). There are so many opinions surrounding treatment plans, but for me, I focused on the data, common sense, and my life goals. My main goal was to live 30+ additional years prostate cancer free, and be available to my wife, son, parents, siblings, etc... I didn't want to have any complications or side effects from the surgery but this was not an absolute need. In the end - There were no complications with surgery and I have full continence and erectile function. I realize there is a 20% chance of biochemical reoccurrence, but thus far it PSA is undetectable - Praying this will be the case for many years to come. There are so many horror stories out there surrounding radical prostatectomies, but based on my research and personal experience, the outcome you have is directly related to your up front research in choosing the best possible center of excellence and the most qualified surgeon at that center of excellence. Then, you must do the post operation therapy that is prescribed.

For myself, leaving the cancer inside of me was not an option. I wanted a procedure that allowed for a complete understanding of the cancer progression (post op pathology) and did not want to rely on imperfect imaging tools to direct the treatment. Also, I had an uncle (only other person in my extended family that had PC) die from prostate cancer. Unfortunately, his prostate cancer was left untreated too long, spreading to his bones. So many men say they don't want treatment because of a possible quality of life reduction. Well, after watching my uncle slowly and painfully die from metastasized prostate cancer, I was quite certain that was not the quality of life I wanted.

At you relatively young age, I would definitely get treated. There are so many treatment plans out there and you need to pick the one that aligns best with your personal life expectations. If people tell you there is only one option, you probably want to ignore there opinion. For myself, I would definitely recommend a robotically assisted radical prostatectomy at a center of excellence. However, this is based on my person life expectations and experiences.

Good luck with your decision!!

Jim