You say..."I’m concern with the muscle loss and other adverse affects...."

Well, the side effects of ADT, are well known, particularly
by members on this forum.

Generally:
Muscle and joint stiffness.
Hot flashes
Genitalia shrinkage
ED
Loss of libido
Weight game
Bone density

To a lesser extent, depression.

The answer...nobody knows, which ones or the severity.

There are mitigating strategies you control:
Diet
Exercise - cardio dnd resistance.

Your medical team may want you to take Calcium and Vitamin D3 while on ADT.

There are medications which can mitigate hot flashes.

Whatever side effects you may experience, they generally subside and go away in the first 3-6 months droning on which agent and how long the systemic therapy was.

Your age, baseline T and which agent may play a role on if, how fast and how high your T recovers after coming off treatment.

Generally, MDT plus systemic therapy demonstrates improved PFS and RPFS in various clinical trials.

There is also data that points to MDT by itself can push back the needs for systemic therapy.

In my most recent treatment, MDT by itself was an option. I said no, there is micro metastatic disease to small to be seen by imaging that needs to be dealt with. So, we did 12 months Orgovyx in conjunction with SBRT.

I am at two years, PSA is stable at .03, T is 400+

Would the outcome be different if we had done MDT only? We'll never know since once you make your treatment decision, you own it, no take backs!

As other have said, careful on statistics, they are often outdated and population based,

I say outdated because the pace of medical research is such that statistics can't keep up.

Population based simply means they may not fit your clinical data exactly.

You are not necessarily "wrong" either way, both are "valid " decisions.

What would I do were I you? Keep in mind, I'm 12 years into my journey, so a lot of experience and lessons learned. I would do the six months, Orgovyx, not Lupron, keep an eye on my diet, exercise, manage stress...my experience has been that ADT has not impacted what I do, just how I feel doing it.

Kevin