@texan1961
My circumstances are very similar to yours. I have 6 tumors. Two are gleason 7 (3+4) with cribriform four are gleason 6 (3+3). Age 63 diagnosed, now 64. Decipher = .72.

My surgeon/oncologist is Dr. Joseph Wagner - Tallwood Health Hartford - renowned robotic surgeon (over 4k) and one of the earliest to specialize in the procedure. I fully expected to have a robotic removal recommended. However, he advised me that my situation was 'equipoise - surgery vs. SBRT (with adt/orgovyx). This was confirmed in second opinions with Smilo (Yale) and MSK. Wagner was very direct -- one treatment was the same as the other. Both are curative in intent and there are no guarantees (cribriform is an issue). In consultation with Dr. Wagner and his colleague Dr. Byun (radiologist trained at MSK/Weil Cornell) I opted for radiation.

My decipher score (high) provided Dr. Wagner absolutely necessary information to help guide his recommendation. In consultation with Wagner & Byun I opted for SBRT (5 sessions vs. the longer version) and am currently in the final 6 weeks of Orgovyx. I am at about 70% of activity with some mild SBRT/orgovyx side effects (voice is hoarse, fatigue, and some muscle and bone aches) - all tolerable with occasional Advil.

I have tachycardia and have only experience one mild episode early on with Orgovyx. I walk a lot, ski, (winter here in New England), and am back to normal functions for the most part (last SBRT was 4 weeks ago). Orgovyx is expensive. It was my physicians first choice and I followed that recommendation.

My advice (gleaming lots of good advice from contributors on this site - especially Jeff M. and Heavy Phil and others) - ask specific & pointed questions of your provider, get a second opinion, stay active. Importantly: find doctors that you Know Are Great. Happy to answer any questions. Keep going - this will work out.