I can see why the ADT before treatment would be helpful; it would serve to shrink the prostate cells encroaching on the bladder wall and give more separation for whatever will be done.
At age 65, surgery is a good first choice IMO. A very skilled surgeon can dissect the cancerous tissue away from the bladder and if you need SRT down the road it should not be a problem.
However, radiation therapy, although extremely precise, does involve a margin of anywhere from 2-5 mms depending on the machine used (Cyberknife vs MRI
Guided. So bladder damage might be inevitable if all the cancer is to be eradicated. And if treatment fails, your options become limited.
I chose surgery at age 64 (kicking and screaming) purely to get a second chance if needed…and it was.
Phil