@seekingclarity
You are getting medical information from two different urologists. Ask your questions to them. They are the only ones who have your medical history and have examined you.

Medical professionals are your first line of getting guidance and if you still have questions asked them. Many of us will get second opinions from medical professionals to help you decide on what is best for you. Many of us feel our mental health is important and that helps guides us on decision like active surveillance, RP, or radiation therapies. You have two different urologists who I would flood them with your questions first.

Was the Decipher test mentioned to you? It is a genetic test to more accurately determine the risk level of your PC. My Decipher was same as yours 3+4=7 and given to me as intermediate risk. I had the Decipher and lowered to low risk.

Based on my Decipher both Mayo Jacksonville and UFHPTI (my second opinion) recommended radiation but no ADT.

You have been diagnosed with cancer. Active surveillance is something to consider but that should be your decision working with your medical doctors, and second opinions, and other test available to help guide you. Your medical doctors (present and if you do more opinions) have you complete medical history and have examined you.

There are some urologist that will do surgery on a patient that has gone through radiation prior. My urologist said most will not try as is real difficult for surgeon because of the condition the radiation leaves the prostate. I don't know anyone on MC Connect that posted doing this. However my Mayo urologist confirmed there are some urologist that have experience and expertise to do RP after radiation but are rare.

Proton radiation is what I had. I can give you my personal experience with it. May I suggest you contacting UFHPTI and request a information handout. It is free and no pressure to go to them. The package will include research on all PC treatment plans, two books on prostate cancer (one is Walsh book) and a complete packet of the program at UFHPTI. It contains a ton of research on PC, diagnosis and treatment options that you can read at leisure.

The cyperknife I do not have personal experience so will no try to comment on something I do not have personal experience with. I did have proton radiation as both my PCP and I liked the added benefit of the beam dose level being controlled going in, releasing is full dose at specific spot and does not continue through body like photon.

You need to get as much information from your medical doctors with all the questions you can think of. Then do your own research and consider additional diagnostic test, and second opinions. Passing on to you what I did, why, and my personal experience with PC as I did just what I posted to you.