@manojsmishra I had gleason 3+4 as well. 10.2 psa. Looked into removal and radiation. Not all radiation machines are alike in terms of radiation exposure to healthy tissue and therefore side effects. Google the Mirage study that compares built in mri radiation machines, such as the MRIdian or the Elekta, to other types of non mri radiation machines. 2 mm margins vs 3-5 mm margins DO have an impact in terms of side effects and toxicity and what you see with the MRI is what you can treat vs fused images.

I was not comfortable with the % of re-occurrence with prostate removal and potential side effects though others were. Once radiated, prostate removal later on becomes more difficult. That was a risk I was ok with.

Once I picked the radiation machine, the MRIdian, I spoke with 5 radiation oncologists from centers of excellence or those that were trained at centers of excellence and made my decision as to where I was going to be treated, which was in Florida. I completed 5 hypo-fractional treatment in February of 2023 with minimal urinary restrictions that cleared up quickly.

By the way, if you are in the New York city area, on Sunday, September 22 from 10:30am-2:00pm at the New York Academy of Medicine (1216 Fifth Avenue New York, NY 10029), there is an event featuring presenters from Weill Cornell Medicine, Columbia University Irving Medical Center, and Memorial Sloan Kettering Cancer Center, to explore critical prostate cancer topics.