@fritzo
The surgical QOL factors (incontinence/ED particulary) are often temporary. If not temporary, there are treatment options to consider. The side effects from radiation are, from my doctors' advice and most of what I have researched, delayed. Appearing a year or 2 later in many cases (not all). Cribriform was my primary concern combined with a decipher score of .72. That concern remains. I am on ADT (orgovyx) - before and after my SBRT. In my consultations the doctors (6 in total - as noted) said one treatment was the same as the other - it was very clear. Neither treatment statistically was better when treating cribriform - physicians from MSK, Smilo, and HHC (Hartford Health). Cribriform, Intraductal, and BRCA (among others) are concerning for patients. I opted for radiation and believe that beneficial research and treatment is evolving pretty quickly for all of us for whatever for the upcoming years hold. Frankly, I consider myself lucky to have good doctors, good resources, and am often reminded of others in this world who face far more challenging cancers in childhood or in more dire situations. Our situations are not ideal, but treatable for the vast majority. Best of luck. Better days ahead and Go Easy.