Hi, Klw23, my husband opted for RALP, with a PSA of 12.1 on the basis of it being contained in the prostate. He was 64, fit and active at the time.
He recovered fantastically from the operation no incontinence or ED post op. Unfortunately pathology revealed his cancer was infact Large Cribriform which had already spread outwards from the prostate (not seen on MRI pre op). The margins were all clear. His post op PSA being 1.9. and his Gleason 4+3. PSA rapidly rose over the following months but 2 PMSA CT scans were negative as he is one of the unfortunate people who don't react to the radioactive material. The cancer was eventually found in a rib by taking HT to cause a 'flare', to show the location. SABR was excellent in sorting out his rib.

He had a torrid time on the HT and ended up with heart and kidney problems (no history prior). Once the HT was out of his system his problems went and he is feeling fit and healthy again. The flip side is now his PSA is around 30, but they can't find the cancer again though they suspect its possibly in a lung (scan results due in 4 weeks). He knows he has to try HT again, aand is debating which one to try. He wants quality of life verses quantity which I understand.

We are pleased he had RALP as we wouldn't have had the hystology otherwise as it hadn't been picked up.
Ultimately its a minefield and only you can decide which option to go for its a difficult decision for everyone but I wish you the very best for your journey.