Regarding the “if I did radiation then surgery was not an option after the fact.”

According to data from the Mayo Clinic (in Dr. Kwon’s presentation), following initial radiation if there is recurrence, half the time recurrence is distant from the prostate so, surgery isn’t even a consideration. However if recurrence is in the prostate, there are other preferred treatment options besides surgery - like focal therapies (because the dose can be specifically targeted), brachytherapy, SBRT, and sometimes even re-radiation.

Treatments have advanced over the decades where the old-school thought used to be “no surgery after radiation.” These days, surgery should be considered as a final salvage treatment only when all other options have been exhausted.

(For a localized, 7(4+3), PSA of 7.9, I had 28 fractions of proton radiation (during April-May 2021) + 6 months of Eligard + SpaceOAR Vue. PSA now varies between 0.35-0.55.)