I chose RP at age 72, and would do so again.
Removing the prostate resulted in a complete pathology report, which confirmed Gleason 9 with EPE (extraprostatic extension, meaning PCa cells outside the prostate). Surgical margins, seminal vesicles and lymph nodes clear.
My PSA was .19 ninety days postop, resulting in Salvage Treatment of radiation to the whole pelvic floor and lymph nodes and 4 mos ADT.
My PSA for a year post salvage treatment has been < .02 undetectable.
My thinking, hopes and prayers are that the RP removed the bulk of the cancer and the Salvage Treatment "cleaned up" the escaped PCa, and that I may have an extended period of time before re-recurrance.
One of my thoughts has been that no other treatment protocol would have identified the EPE, and resulted in prompt treatment of it.
All of that said, Radiation, as primary treatment, is a very reasonable choice for others.
However, I wonder what would have been developing over time from the EPE if it had not been detected by postop biopsy and treated.
Also, I was initially diagnosed by a surgeon at a teaching institution, but had a 2d opinion and surgery at a COE, which I believe made a dramatic difference in my outcomes. I recognize however that there are excellent surgeons at other institutions and practices and everyone does not have access to a COE.
Best wishes for a successful treatment.