As Jeff says, Gleason 9 is high risk. I was a Gleason 10 and had a robot-assisted radical prostatectomy this October. Post-surgery news is good. I will be watching my PSA for the rest of my life regardless of the treatment I chose. After talking to the doctors and my own research, I decided total removal was the best option to help lessen the chance of reoccurrence and provide more options should it reoccur. And the consequences - incontinence, ED, ect. (all of which will most likely improve with time) were for me, less than the other treatment options. As others have said, all of us weigh the factors differently and will do what we think is best. Research and working with your doctors are key to your informed decision. I sat down and talked everything over with my wife, who has been very supportive, and decided on the way forward. Discussion with whomever is in your life helps. Best to you and yours. Dave.