My journey is similar to cs2024. Multiple consults surgery vs radiation. Had an ArteraAI test which suggested no measurable benefit by adding ADT - chose no ADT at least for now. That's an interesting story ...
MRI PI RAD 4 - 15 core biopsy 10 3+3= Gleason 6 - 5 3+4 = Gleason 7. PSMA no visible metastasizes. Diagnosis for me is UNfavorable Intermediate PC because of volume. I'm 71, PSA topped out 5.3 this year watched it for 10 years. One of my consults was with the Dept Head of Urology at Moffitt. He said flip a coin between surgery and radiation. Statistically each offered similar 10 year outcomes. I chose radiation IMRT/28 treatments with lymph nodes just in case.
The bladder prep is irritating ( I have 7 left and counting the days).
No perfect answer. We are all different.
Tech is your friend. Constant changes. Always something new.
Good luck.