All good points . What is yoru PSA ? At Gleason 8 you dont want to take that lightly What about operation, or maybe you have other comorbidities or just straight out your age preclude you from having a prostatectomy. They are effective as well as radiation. Surprisingly the outcomes are very very similar. Radiation and the operation are the two modalities that seem to be the most successful. I had the operation about five years back at PSA five. Gleason 3+4. My phone is he didn't buy them out but slowly climbed up to 0.14 ... This was a migration after three years of my operation. So two years ago I submitted myself 222 sessions of external beam radiation. The radiation oncologist said with the steep family history let's not wait till 0.2 and go after it now at 0.14 .THey did the Pelvic floor bed . I was too early for a PSMA -PET scan . It usually needs to be above 0.4 to get any sort of a target bounce . God Bless Sir ! James on Vancouver Island