You appear to have been diagnosed as "high risk". My case is somewhat similar. The way the docs describe my case is

"PSA 7.7, cT3b, GGIII (4+3), 5 of 12 cores, biopsy proven seminal vesicle involvement, no PNI or EPE. There was "no evidence of metastasis" on the PET scan, but the report stated there was "no prostate uptake" of the radioactive indicator.. My doctors agree my case could be described as "localized", but they usually call it "high risk".

The "high risk" means it is common when a case appears localized like this, and hence there is a good possibility of long term "cure" or remission, that the cancer may have already migrated undetected to distant areas of my body, or it soon will. So they want to hit it hard, and they try to minimize how hitting it as hard as they do will have on our quality of life. It has to be stressful to inflict such suffering on people who otherwise look and feel healthy, so I suppose it is natural for them to try to minimize what is bad for us in what they do.

Don't believe the voices you hear that prostate cancer is just an endless roller coaster that never ends. Many patients are treated once and no amount of monitoring finds cancer for the rest of their lives. Old age is incurable. Prostate cancer often is.

My radiation oncologist (RO) appeared to have no doubt in his mind that my treatment would be what is prescribed for you, i.e. external beam radiation therapy + 2 years of ADT. I agree with you that its the ADT I'm most concerned about.

So, I don't know what you should do. What I am doing is researching to find out if this RO has recommended what is best for me. I don't think he has. I've presented evidence to him and he has scheduled an appointment to re-evaluate my case.

The type of thing that impressed me:

A presentation by Dr. Nelson Stone at the 2024 Prostate Cancer Symposium "Radiation Dose and Hormone Therapy: How much is Enough?" This guy has been banging on about this for many years. The organizations that set the guidelines, such as the ones your RO and mine followed when they sentenced us to 2 years of ADT, take time to change.

Eg: on a relatively minor point. This guy published in 2013 saying he had discovered that gland size was not an issue when considering patients for brachytherapy, and it took until 2022 for the Europeans to change their guideline, and the US has not changed yet. My RO initially rejected my request for brachytherapy boost on the grounds my prostate was too large. I pointed out this guy's research, what the Europeans did recently, and I expect him to change his mind on that point or I'm heading off to somewhere else.

An article that restates what Dr. Stone is saying was published by Manuj Agarwal in the ASCO Post last year: https://ascopost.com/issues/march-25-2024/brachytherapy-boost-may-decrease-the-duration-of-androgen-deprivation-therapy-for-high-risk-prostate-cancer/

It took me a long time to figure out what these oncologists are talking about, enough to gain a minimum level of confidence to disagree with the one I'm dealing with.

I always understand that I may not have a clue about what I'm talking about, and in any discussion with a professional, all I do is point to the most highly regarded guideline setting organization, or the most highly regarded researcher, or the most highly regarded practitioner that I can find who is saying something otherwise.