I have zero regrets about my decision to get surgery. Like most guys who have gone through this, I asked myself the same questions you are asking - should I or shouldn't I? In the absence of a magic pill to fix prostate cancer, you have the two leading treatments and all the less popular options.

The decision for surgery wasn't made without significant research and it was recommended by nine doctors - that's enough for me to say it's the best course of action for me.

As it was put to me, by pretty much everyone: at your age there's no argument that surgery is the best course and it still leaves all the other options on the table if you need them. I'm 54, so every doctor felt my ability to overcome any side effects and recover easily was high. I also had a cancer that was not as advanced as many on here, meaning surgery was likely to be a one-and-done treatment (fingers crossed).

The other thing that I think is neglected in this conversation is that I was told repeatedly that, at 54, radiation now meant that I was not only likely to see the side effects of radiation in my life but it was almost guaranteed. Radiation can cause other cancers and other issues later in life and you should talk to your doctors about those things. It's one of the reasons that if you are on the younger side of the spectrum, say sub 70, doctors recommend surgery because you would see those radiation issues - but at 70+ it's less likely that you'll live long enough of a natural life for those to have a serious impact.

None of the treatments are a magic pill. With RARP you might be incontinent or have erectile disfunction (I had neither) - both of which resolve in the vast majority of men. With radiation you can also have both of these things plus risk cooking your bowels, leading to bowel incontinence as well - or perhaps bowel issues later in life. With the other treatments, such as Cyberknife and TULSA PRO, these newer procedures don't have long efficacy data so there is no guarantee that they are as effective after 10-15 years as radiation and surgery have proven. Everything has its risk, everything.

I think you are likely to get a different answer from everyone who isn't in the medical profession who deal with this every day. I spent countless hours on Google Scholar, talking to doctors, and taking the comments here into consideration (and verifying what I read with other sources because none of us know one another).