time to decide and I'm stuck....

Only you can decide what's best for you.
But for me, when I was looking at surgery vs radiation (Gleeson 4+3)
Surgery - immediate bladder incontinence & ED, but may all resolve within 2 years
Radiation - everything's all good for a few months, then bam - ED, bladder & bowel incontinence.
Bowel incontinence was a hard No for me.
So I got the chop.
But they do use a spacer to reduce the prospect of bowel incontinence after radiation.

Here comes other opinions...

Most of my friends that had immediate risk PC decided on radiation and have had few problems. However, I know some other guys who had their prostate removed and ended up having the cancer come back and then had radiation, to destroy what cancer remained.
The general consensus is:
For intermediate-risk prostate cancer, surgery removes the prostate and gives quick PSA results, but carries risks like urinary incontinence and erectile dysfunction and requires a recovery period. Radiation avoids surgery and has a lower immediate risk of incontinence, but treatment takes several weeks, PSA drops slowly, and side effects can include urinary or bowel irritation and gradual erectile changes. Both are effective—choice depends on personal health, side-effect priorities, and lifestyle.

Age is a major factor but you don’t give us a clue. As low level as your cancer is radiation would probably make sense. While the side effects from surgery are sooner the results of either radiation or surgery are about the same long-term.

You could consider having proton radiation, which gives you lesser chances of a side effects.

I had surgery 15 years ago because my father had radiation and he died from PC. I do have a genetic problem, however, So nothing was going to stop my cancer from coming back.

(1) Jeff's question about age is spot-on, that is critical for consideration. (2) Another thing to consider and share is your PSA doubling time. (3) Ask your doctor about a genetic test, that will give you a peace of mind of whether you can truly get rid of the cancer. (4) How is your health, if you are in good/great shape, the recovery time from surgery can be quick.

With these additional variables, much more insight will flow your way. Take your time, breathe and good job being educated, that is the first milestone and you are there!

wpg215, it is a tough decision because you can't know ahead of time. I'm partial to the 5 fraction MRI guided radiation treatment. I think it's your best chance. I'd have it with a space oar. This video is pretty convincing.
https://www.google.com/search?q=amar+kishan+video+5+fraction&oq=Amar+Kishan+&gs_lcrp=EgZjaHJvbWUqCAgCEEUYJxg7MgoIABBFGBYYHhg5MgYIARBFGEAyCAgCEEUYJxg7MgYIAxBFGDsyDQgEEC4YrwEYxwEYgAQyBwgFEAAYgAQyCAgGEAAYFhgeMgYIBxBFGD3SAQg3NTEwajBqN6gCALACAA&sourceid=chrome&ie=UTF-8

For us choice was simple, my husband always preferred surgery idea even during AS period. When the time came for treatment both his urologist and RO said that RP could give him a better result since he had cribriform and IDC found in his last biopsy. My husband also liked the idea of having a second treatment available if needed (if there is a recurrence). Once you have radiation you can not radiate the same spot twice and having surgery after radiation is very hard task. It is rarely done and than side effects are much more pronounced than with initial RP.

Yes- as others said the age is very importance factor. For younger patients RP is preferable, while for older than 70 or more RT might be more suitable depending of general fitness and life expectancy.

Regarding side effects, they are the same on the long run, and even during RT people can get cystitis , proctitis, diarrhea, urethral constriction etc. Some people do not have any of those during RT and also some people do not have any incontinence nor ED after RP recovery period.

I do not quite get what you were referring to when you mentioned "pulling back my member" since for my husband nothing was pulled back lol - same look, same length , same everything 🤷‍♀️ .

Wishing you the best of luck with whatever you choose for you initial treatment 🍀🍀🍀 !

It's a tough decision. I was 70 last year when I was diagnosed with 3+4=7 grade 2. I'm not a medical professional and I certainly have no idea which treatment would be best for you. That said, here's my story: The MRI indicated my PCa was contained in the prostate. During the consultation I asked my very experienced CCOE surgeon what he thought my (case specific) odds were for incontinence, ED, and whether I was a good candidate for surgery. He told me for my case he thought he could spare my nerves and that my odds at 1 year after surgery of being continent was 90% and 70% for regaining sexual capability (assuming I was capable before surgery), and that I was a good candidate for surgery. I thought those odds sounded pretty good, and I was also getting some family advice pushing me towards surgery, so I went with surgery. I was immediately continent after the catheter came out (except for some minor releases as I figured out the new normal). I did experience ED but daily 5mg Cialis (plus either a higher dose of Cialis or a dose of Viagra on days I want to have sex) has helped a lot and at 15 months I was back to my pre-surgery sexual capability. Further, I've been able to resume all my pre-surgery physical activities. One thing that's actually better is that now, without my old enlarged prostate, I urinate like a 30 year old. The surgery also gave me the benefit of a pathology report on my prostate, which found both cribriform and IDC present. So I was pretty glad I choose surgery plus I do know if it comes back I want to aggressively treat it. Bottom line: picking surgery has worked out great for me, but clearly not everyone is so lucky. I do believe the experience and expertise of the surgeon is crucial to a good outcome, so since I had access to an outstanding surgeon that made the decision a bit easier for me. All that said, whatever treatment one chooses it's impossible to know how it's going to turn out, so it kind of comes down to trying to decide which treatment seems best for you and then never looking back. Best wishes.

@surftohealth88 I believe that's a reference to possible shortening of the penis due to the urethra being cut & then stretched back up to join at the bottom of the bladder.
Not much else to say about that. The jokes write themselves.

@peterj116
Ah , OK lol, luckily nothing looks "pulled" in our case 😆👍
One more reason why it is very important to find "super experienced" surgeon, I guess.

@peterj116 -- I thought that as well until I ran across the Mayo video below. I believe the bladder is dropped down to make up for the prostate removal. The penis isn't pulled in. But the nature of the penis soft tissue is such that without the normal nighttime erections, the soft tissue of the penis tends to stiffen/scar and it simply can't stretch as far later. Here's a link to one of the Mayo urologists who was (I think) part of the study that figured this out. He explains starting at 15:00: