@copyman

There is about the same rate of BCR for RP and RT but after RP one can have salvage RT as a second chance for cure. (Yes, they call it "salvage with curative intent").

Radiologist like to say that there are additional radiation techniques that can be implemented post RT - yes there are, but with less success and much bigger post radiation toxicity. Not to mention that salvage RP is with much higher incidence of incontinence and ED is almost warrantied and it is very, very rarely done.

There is even a new line of thought that with immunotherapy RP will become even more implemented as a "tumor de-bulking" first step, but that is another story ...

Bottom line - BOTH therapies have their pros and cons, BOTH give about the same result, BOTH can cause ED and incontinence but in reverse time span, BOTH groups of patients will have almost identical OS rate.

It really comes to one's personal preference - what looks less off-putting to you ? For my husband being on ADT that can cause numerous side effects and having RT for two months with possibility of secondary cancers was more scary than having surgery. Now that he will probably need salvage he is happy that he had RP and now has a second chance for "cure". He has zero "buyer's remorse" - ZILCH.