Bobv48, looks like you have received a lot of great advice. For myself, If you are in good health with no other life limiting issues, I am an advocate for addressing the prostate cancer versus letting it grow and potentially metastasize. I was 55 when I was diagnosed with PC (Gleason 4/3), was in excellent physical shape, no other comorbidities, and had an want for 30+ additional years of cancer free life. I did all the research to ensure I picked a center of excellence (Mayo-Rochester), and went with a robotically assisted radical prostatectomy. I am 1.5 years out from surgery and all looks good thus far --> PSA undetectable, fully continent, and erectile function back.

In my opinion, age is a number, and you should make a decision on your personal physical and emotional health. If I were in good shape at the age of 72, I personally would want 20 more years of cancer free life, thus active surveillance or watchfully waiting for the cancer to grow and possibly metastasize would be off the table. However, if I had other comorbidities, this decision would obviously change.

In my opinion, the biggest advantage of surgery is removal of all known cancer and having the ability to perform a post surgery pathology to define margins & evaluate the cancer more thoroughly. Other treatment plans rely on imperfect imaging and biopsies to guide the treatment. I have personal family history (uncle) and read about far too many men who went with a less invasive treatment plan and lived to regret it. For myself, life was my #1-need, with a high want for continence, and a far lower want for erectile function. In the end, the only treatment plan that made sense for my personal situation was the radical prostatectomy at a center of excellence (with the best surgeon I could find). From what I have seen, men that do not utilize a center of excellence are at a far higher risk of incontinence, impotence, or other complications.

As always, the above comments are my personal experiences. Each man has to decide for himself what treatment best fits his wants/needs. In the end, we need to be confident in our treatment decision and live with the consequences.

Good luck on your decision and hope all goes well.

Jim