The answer to your question is “what do you want?” You’ve probably reviewed all treatment options, success rates, side-effects, quality-of-life expectations during and after treatments, etc. What is your treatment preference?

With prostate cancer, the choice of treatments is totally up to the patient (& the insurance company, of course!). Prostate cancer treatment is one of self-advocacy and shared-decision-making. You are the one driving this vehicle; doctors are there to provide medical advice and recommendations. They’re not likely to give you a firm, absolute decision like “That treatment method is best and will work.”

This is yours; you have to live with the results; you know yourself better than anyone else; you will have to make the final call. (You say that you’re leading towards radiation. Why? Understanding that will help you come to a final treatment decision.)

(With a localized, 7(3+4), PSA of 7.976. I had all the same options and after a thorough and in-depth analysis, I chose radiation and informed my urologist of my decision. Working with my radiologist, I chose 28 sessions of proton radiation. Prior to starting treatment, a second opinion on the biopsy slides increased the Gleason to 7(4+3), so we added 6 months of Eligard (and brought on a medical oncologist to manage that). I had treatments during April-May 2021. PSA now hovers between 0.35-0.55.)