Gleason eight is aggressive. Along with the ductal cancer issue You really need to do something soon to prevent it getting out of the prostate. Have you spoken to more than one urologist about having surgery? I’m not so sure about the radiation oncologist telling you that the chance of recurrence is so much higher with surgery. Surgery will completely remove the issue and you can then have salvage radiation if needed.

You might want to consult with an oncologist about this?

Are you at a center of excellence? You are a prime case for needing a top notch group of doctors to give you advice. Is there a mayo clinic near you?

Another thing I could recommend is going to an Ancan.org meeting and getting advice from the people there. they’ve been helping people with prostate cancer for 15 years and there’s always at least three doctors at the meetings. the next one is next Tuesday. You could go to the website and sign up and come to the meeting, being new they would talk to you first, and they would give you advice based on many years of experience with treatments for people with prostate cancer. You should find a center of excellence to advise on treatment as well.