Welcome to the club no one wants to join. I was diagnosed with PCa last year when I was 70, 3+4=7, Grade group 2, contained to the prostate. I'm reasonably fit but not excessively so. I'm not a medical professional and I have no idea which treatment option is best for you. That said, I'm happy to share my decision and how it's worked out for me. My wife and I chose surgery. I had NS RARP by a very experienced surgeon June 2024. I did start Kegals about a month before surgery and resumed them after surgery when the care team approved it. I don't know if the Kegals helped or not, but I was never incontinent (although it did take me about 5 months to figure out the new normal and get all my confidence back regarding urination). Recovery from the surgery was easy for me and exceeded my expectations. I did have ED at first, but it's been slowly getting better and I am able to now have intercourse with my wife (although I still have a way to go to get back to normal). At 9 months after surgery I'm fully recovered in all other ways. I can go to the gym, hike, etc. Other than the diminished sexual performance, my quality of life is as good as before surgery (and my urination is actually better as my flow is much improved). For me, my worst day was right after surgery and every week has been a bit better. I am happy with my decision to have surgery, but during the first couple months I did have some doubts occasionally. But at about 4 to 5 months I crossed a turning point and now I'm really glad I had the surgery. I do have a recommendation: Buy Dr. Patrick Walsh's Guide to Surviving Prostate Cancer Paperback – October 3, 2023. It's on Amazon and it's the best $20 I ever spent. It really helped educate me on some key points in my decision making and it's organized so you can easily dive into the sections most relevant to your situation. For me, when considering surgery I was very interested in the experience and results of my surgeon. I also specifically asked him if he thought he could spare my nerves and what my odds of incontinence and ED were. Well, that's my story. But as I said, I have no idea what's the best treatment for you. Best wishes.