When I had very similar numbers (65y; 3+3 & 3+4; no cribriform pattern, PNI, SVI, ECE, or intraductal carcinoma); had CT, MRI, and bone scans: no indication of spread; for me quality-of-life was equal priority with successful treatment for such low-grade disease.

Similarly, I made the personal choice against active surveillance. (What reasons did they give you for recommending against active surveillance with < 5% of 4?)

I used SpaceOAR Vue (more advanced than regular SpaceOAR Hydrogel).

However, I chose 28 proton radiation treatments over 5 SBRT treatments. (I had treatments during April-May 2022.)

SBRT is a great option with a history of successful results. But, I opted for lower doses each session to lessen the possibility of urinary bother. (Plus proton’s Bragg-Peak characteristic was technically and scientifically appealing to me.)

I didn’t view it as “pick your poison” rather as choosing from a number of good options one that best fit all the priorities that I was looking for.

If you’re a candidate, there are no wrong choices when it comes to radiation technologies these days - you have many good ones to choose from, including SBRT.

Once you’ve decided and settled on all of your priorities, you’ll have no trouble making the decision on a good treatment that’s best for you.

(In my case, right before starting proton radiation treatment, a 2nd opinion came back as 4+3. Not knowing which was “right,” we added 6 months of Eligard to my treatment regimen.)