I am a Canadian, living, and having been treated in Canada. I had prostate cancer dignosed early May 2023. My PSA wa 13.3, and following biopsy my Gleason score was determined to be 7 (4+3) high intermediate. Attached to the nerve bundle, my cancer was agressive in nature. I was given choices of radical prostatectomy, HDR (HIGH dose rate) Brachotherapy (Temporary radioactive seed placement), radiation and hormone therapy. I chose the latter THREE. I am two years and five months post treatment. PSA is 0.03 and Testosterone varies between 5.5, and 9.0 thus far. (US meaurements are different). So far so good. For one year, ED, then second year I could feel everything, but no pre-coital, or ejaculate fluids. That remains the same, currently. I am 68 years old so that doesn't matter to me much. Being active does, so that much is good. Recently a mass in lung 6.5cm was found and biopsy says no cancer. Mass grew more so further tests bein arranged. Not sure if this is related to prostate metasticising or not. It does seem that the initial treatments have been successful, but that will be confirmed later. Treatment is a personal choice, one I made with my wife being fully informed, and included in all considerations toward my choices. Good luck, and I do hope this offers a bit of outside insight for you and others.