Well I think you have to move on from your Urologist to a Radiation Oncologist and more than one of them.
Urologists can’t really offer you much at this point except surgery, which is probably very risky unless done by someone who does resection post radiation all the time.
From other men I’ve spoken with - and my own experience - find a young RO! They are not prejudiced by outdated studies and business as usual - they are up on the newest techniques made possible by advanced digital software and machines far better than even a few years ago. Best