I had surgery two months ago. I was actually locked in completely on surgery as the best option for my situation (3+4=7, contained on imaging, somewhat aggressive profile with Decipher score of .61) I chose surgery because I felt it gave me the best treatment options if I had recurrence.

Short version: everything went very well. But, there were bumps in the road during my decision process.

Four days before surgery, in an online support group meeting, the moderator (who provides medical care in hospital settings) and a focal center doctor did a 90 minute presentation explaining that focal therapies are where everyone should start (small caveat of if you qualify) because surgery is so terrible. It was literally 90 minutes of focal therapy great, surgery bad. At the end, the moderator told me that I need to reach out to my surgeon and cancel if I had doubts, even cancelling up to the point of being rolled into the operating room. (he knew nothing of my imaging). I didn't have doubts until they told me for 90 minutes that surgery is bad and Focal is good. It shook me up. I then had to do a bunch more homework to realize many things;
• Many insurance policies do not cover focal therapies because several are still considered experimental.
• The recurrence rates after focal treatment is really high (so it's sort of kicking the can down the road approach)
• And finally, my cancer location made me not a good candidate for focal.

Which is not to say that there aren't tons of people who get focal therapy and have great success. It just wasn't right for me and I didn't like the recurrence numbers. Focal might be right for you. It just wasn't an option for me.

After that, I was locked back in on surgery 100 percent. Yes, recovery takes time and managing the side effects takes time. In my case, my surgeon said that my post surgical pathology report was "as good as it gets." I was very fortunate and this isn't the say yours will be the same. But, surgery was the right choice for me.

If you don't have spread past the prostate, I've heard people describe surgery as the choice of doing the surgery, getting through recovery and then living your life. But, everyone is completely different. Their pathology, their numbers and how their body responds.

So, I don't know your medical pathology, so I really can't advise what is right for you. All I can do is share my decision process.

Whatever you decide, you just have to own it and move forward. Hang tight-you got this.

(side note: when I told my son, who is a rehab doctor about the support group moderator and what he did , my son said that their behavior might not qualify as malpractice, but definitely was unethical to advocate medical treatment without knowing my pathology and medical situation.)