@paullvlc
My brother at 77 had five sessions of SBRT radiation. His PSA has pretty much settled down in the three years since. He did have small cribriform And it doesn’t seem to make a difference.

At your age, there’s no reason you need to have surgery, SBRT radiation is very common.

See what the pet scan shows, If it is clear then that’s probably all you need.

They did give him ADT for six months because he had a Gleason 4+3. The only problem that caused was some hot flashes. The radiation caused some cystitis and he had to take Flomax every other day for a couple of months, but then everything cleared up.

You don’t mention anything about your diagnosis, That could make a big difference. What was your PSA? What was your Gleeson score? Did you have a decipher test?

@paullvlc side effects are loss of hair, low T, fatigue, weight gain. I was Gleason 8-9/ metastatic to lymph nodes, seminal vesicle. ADT-28 months of treatment/28 RT trips.. Been < .01 for over two years. Jeff Marchi is the Einstein on this Mayo forum. I m a novice reporting to you my ADT results. I m 77 today in remission.

@paullvlc I was 77 with a good quality of life and loving sex at 40 yrs of marriage. I had surgery, radiation and 2 rounds of Lupron . My quality of life is gone and wish I did nothing. Only you can make such a serious decision. I’m almost 2 yrs post surgery, no sex which for some is mentally very difficult. My numbers were 3/4 and 4/3 I will always miss the way I felt before my decision