I was 67 gleason 6 3+3 with only 1 out of 12 cancer and no margins. Post op confirmed. I would do RP again. I have both issues. My father was similar. He chose treatment. Cancer came back at age 80 with a vengeance. He lived to be 85. I had two guys at the gym both had RP and neither had issues. I am 73. No other treatments. Pet scan was clean. PSA < .01. Testosterone at 680. My issues are troublesome but I dont worry about whats next nearly as much. I think if I had used Mayo clinic maybe a different outcome. That is probably my only regret.

Michael, that’s a good analysis of one vs the other. My decision to have surgery at age 64 (even though it was my least favorite option) was partly because my surgeon said that a Gleason 4+3 unfavorable had a higher chance of recurrence; I could then do salvage radiation /ADT. However, the reverse treatment was much more difficult and he had done quite a few of these salvage surgeries and complications were high.
So that, in addition to excellent health, formed my decision. A good one it turns out, since I did indeed require salvage treatment.
My friend, on the other hand, is overweight, diabetic (controlled), and has hypertension (as do many of us). And exercise is not a big - or even small - part of his life.
He said he was scared to death of bladder and bowel issues and just terrified of surgery “down there” in general.
So why go thru any of that when there are alternatives on a par with surgery? Of course, many men over 75 still choose surgery for their own personal reasons but for me - and my friend - the least upset to the system is the best way to go - especially when the new life expectancy tables say that 76.5 yrs is the new average lifespan. In other words, recurrence may never happen😳!
Phil