Do you regret having had a prostatectomy vs. radiation, or vice-versa?

Consider that these are most popular procedures hence the most popular feed back. Suppose there is a X procedure/technology that is superior for your particular case. Would you hear about it? Would your team of experts know about it? Do you trust your advisors? Are they current with recent research,advances and technology? Advice: be more knowlegable high level point of view... you are general contractor, they are the subcontractors. Not an easy decision.
>Thus far it seems pretty 50-50 with RP or RT

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).

Just want to, as originator of this discussion, thank everybody who has responded so far!
Lots of very thoughtful, honest, revealing, and often vulnerable comments, and I'm so happy for those who have had positive results--for either approach--as well as truly sorry for those who have regrets for the path chosen.
Thus far it seems pretty 50-50 with RP or RT, and I think I have decided to go with the RALP, given that:
1. I feel still young and vigorous enough (What?! You're in your eighth decade of life!! Obviously in denial...) to do okay with fairly major surgery (it's only "golf ball sized", right?)
2. Although radiation is apparently equally effective and has improved, I would also apparently need hormonal therapy, and that has some big potential downsides. For example, fatigue for me is already an issue due to Long Covid.
3. I like the idea of it being (potentially, I know) "one and done". That is, I'll be immediately confronted with some of the unwanted effects that will HOPEFULLY subside, as opposed to a delayed reaction of side effects from radiation that typically take months or even YEARS to manifest. Also it offers immediate analysis of the actual current cancer state.
4. If one process is chosen but proves ultimately unsuccessful, or only partially successful, it's much "easier" to get RT after RP than the converse.

I still have a CAT scan upcoming, which might potentially put things in a different light, although the radiation oncologist, interestingly, thought that unlikely. Fortunately, I happen to live in a city with a large university that has an NCI approved cancer treatment center, so I'm in good hands with both treatment approaches, and both doctors described quite good results with their many years of respective experiences. In addition to the radiation oncologist and the urological surgeon, I've consulted with a very senior urological oncologist.
Meanwhile, I am trying to be religious in my observation of the Ritual of the Holy Kegels, with the help, thus far, of a charming Australian lass on YTube.

So again, thank all of you so very much, my Prostate Pals-in-arms, and let's keep this discussion going since I'll certainly be paying attention, plus it might benefit others wrestling with The Decision!

My Post op PSA blood work is coming up soon and I will know more after I get those results. Do I regret having a RARP. My current answer is No I do not. I have little to no incontinence and I'm slowing regaining my ability to get an Erection. My PT for my Pelvic floor was a success and I no longer dribble, etc. My life is returning to normal and overall I am feeling better.

Hey Jayhall,

congrats on the Qof Life. can you tell me when you got the RARP? and how old you are???

RARP would be good if it was guaranteed - I wonder if death would have been better.
EBRT would be good if it was guaranteed - I wonder if death would have been better.
SBRT would be great if it was guaranteed - I wonder if death would have been better.
ADT SUCKS - I wonder if death would have been better.
Erections - ha ha
Peyronie disease - gimme a break guys

Sorry - not a cheerleader for this fucked up condition

I'm with you. Urologist wants to RARP, Oncologist wants to SBRT. Turned down by Mayo for Tulsa Pro, going to Moffitt for IRE consultation. If that fails, I may let it play out as earlier death may be better than RARP or ADT. I'm 67, 4+3. Still searching for decent alternatives.

You could also try radiation without or only short-term ADT. Would give you better odds than doing nothing.