Yes, definitely relieved although somewhat anxious about incontinence outcomes. The two most experienced surgeons I've seen (plus the ROs at MD Anderson) have recommended surgery. Although I was holding out some hope for MR-Linac RT, it would have made an already unclear situation even murkier if they'd recommended that.

My experience at MD Anderson was really good. After the the various assistants and nurses took vitals and verified my records, I met with one of their Urologic Oncology Fellows first. After an unwanted (probably both ways) prostate exam, she prepped me that they were going to recommend RT. She also mentioned that Dr. John Ward - the surgeon I met with - is the best she's ever seen, including her residency at Mayo Jacksonville.

That was confidence inspiring, although Dr. Ward didn't really need the assistance. He was great - no rush, explained everything, answered all my questions. They would do an MRI a few days before the surgery. I asked about urethropexy - he performs a Retzius-sparing/hood technique with a Foley catheter for 10 days. He's found better short term incontinence outcomes with that combo. I'd stay overnight in the hospital, and then able to return home the following day after discharge. Patient self-removal of the catheter is common (probably due to travel - I didn't ask). Interestingly, he doesn't remove lymph nodes - says the risks outweigh any benefits. Post-RP PSA > 0.1 is the trigger for more treatment.

I did schedule the surgery for June 25th to lock in the date, but I have one more appointment with a surgeon in Columbus, OH next week (he has 8-9k Da Vinci surgeries). Unless something unexpectedly odd happens at the initial appointment, I think it's going to come down to the logistics I feel most comfortable with between Houston and Columbus.

No threshold from the ROs - maybe case-dependent?