@jonathanack That’s the personal call that the urologist/oncologist can’t make. I don’t know too many diseases/illnesses/injuries where the first choice is to amputate.
For me, the treatment decision was a relatively easy (but time-consuming) choice. One of the understandings I had with my doctors was that quality-of-life and successful treatment were equal priority for me. That set the basis for us working together and agreeing on a treatment plan. So, with success rates comparing surgery with radiation being statistically equivalent no matter what treatment chosen, it all came down to side-effects and quality-of-life.
So, I put together a spreadsheet and listed across all treatment options. Then I listed down all possible & possibilities (%) of side-effects from each type of treatment, and gave each one a score. The one with the lowest total “score” ranked highest. We then took that list, and narrowed it down based on the preventions available related to each individual type of treatment.
I then “scored” the quality of life priorities that came out of my personal introspection, and compared that final score result with the treatment options score result. The score that was closest matching was my 1st choice: Proton ranked 1st —> then IMRT —> then SBRT —> and last was surgery.