Doug you have some great experiences here from the guys I see . Both options look good . Its always worth consulting with each Dr's again ( the RO , and Urologist ) . tel them of your concerns . You are young and healthy so both options look like a 'go' . Keep the health routine up , as it helps with recovery ! I am 61 now G 3+4 and PSA of 4.5 when I got surgery . Surgery left a trace PSA , that was rising very slowly up to PSA 0.14 , so 2 years ago I got External Beam Radiation ( EBRT) . So at 0.14 I got only 22 sessions of radiation . At first the radiation didnt do much as after radiation I was at 0.11 for the longest time , then after 10-15 months it started down to 0.076, then 0.052 , now 0.041 .... This is without any ADT or drugs . I feel fine , Hike everyday 8-15 km's with the dogs , Suana afterwards , and enjoy life . ED was an issue right after operation , but after 3 years its 80% back . Radiation of 22 sessions gave me a jumpy bladder and Jumpy colon for 4-5 months , but that resolved too . My father died from PC when he was 67 , diagnosed at 60 , and that was 28 years ago - so many things have changed since then ! Different world . He was an engineer too - Chemical and he hated Dr's . Thats one reason he was diagnosed late I think , he never went to Dr's , but had to prior to one overseas trip - thats when they found it . It must have been there for a while . I cant remember what his PSA was , but I was his caregiver and man !!! , it was tough on me as a young man ! Let us know how you progress . Keep a book of all conversations with Dr's and all your lab and images , et al . God Bless Sir ! James from Vancouver Island .