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.