I can only share my own experience and how I got to my conclusion, the rest is for you to be an advocate for your own health and take the steps needed that you feel are best for you.

I also had a Gleason 3+4 and, at 54, was told that surgery was preferable to radiation because I had enough years left that I would likely experience the long term impact of radiation before my natural life was over. This was explained to me that this might be recommended to a 75 year old man because their natural life was shorter.

People told me here "surgeons will recommend surgery, radiation oncologists will recommend radiation" and it sounds like that's what you got. But I can say that I spoke to nine experts: 3 x urologist, 3 x radiation oncologists, 3 x medical oncologists - and this doesn't include other disciplines that have loads of experience with prostate cancer patients but don't do the procedure. In my case, every single one of them gave the exact same advice. Now, these doctors were not in the same hospital, network, practice or anything else - I intentionally varied my search across locations to make sure the opinion was as unbiased as possible.

Adding to this, I also read dozens upon dozens of research papers (not opinions, actual research) that back up their recommendation.

Their advice was unanimous but beyond that it made sense to me: we don't know how bad the cancer really is until we remove the prostate and analyze it. Radiation doesn't do that. Biopsies don't do that. PET scans don't do that. MRI's don't do that. All the other methods give little glimpses here and there, but removal tells the whole story of the prostate, even if it doesn't yet reveal if it's gone beyond there all the time (hence the need for PET scans).

I haven't yet had my surgery, it's in about a month, but while I'm concerned with life after this I am 100% confident that my decision to have it removed is the best one for me.

There are other procedures, but while some people have had wonderful success with them, they are still considered experimental or "on the edge" and in most cases I found the efficacy of these alternative procedures could not backed up, some of that is the lack of extremely in-depth research of the available data - which is limited because they are new enough as to not show too much long term data (as in 15 years worth).

This was my experience up to this point.