I was diagnosed at 58 in late 2023. I had a PSA 14.7, G 3+4=7, low-intermediate Decipher risk, and no spread. I looked into surgery and decided the potential downsides, including a possible need for salvage radiation down the road, were too much to bear. Moreover, the surgical side seems to have peaked in the early 2000s after Dr. Walsh introduced robotic surgery to the menu.

On the flip side, radiation and other non-surgical treatments seem to have advanced a faster pace to deliver better outcomes with reduced side effects. I opted for a six month course of Eligard, and five rads of SBRT (TrueBeam STX) in early 2024. Fast forward, my last followup in December revealed a PSA of 0.08. Whatever side effects, such as fatigue, bloat and hot-flashes, I had have largely abated, and my strength and muscle tone are coming back. It's a long road, but I feel great and my RO is very pleased.

My advice: Take your time, explore all your options, ask questions and don't be afraid to get other opinions. Self-advocacy is so critical here. None of us has the same path, and what worked for me may not work for the next guy. Best of luck, warrior. You got this.