I was diagnosed with Gleason 7(4+3). In my case, I was advised by my medical oncologist that robust resistance-training (any load-bearing) exercises offset the metabolic effects of ADT and greatly minimizes side-effects. (Already a gym rat, that was easy for me to incorporate.)

I chose 28 fractions of proton radiation + SpaceOAR Vue injection + 6 months (two 3-month injections) of Eligard. That was 5+ years ago. My wife later told me that if she hadn’t known I was undergoing radiation treatments, she wouldn’t have realized it from any change in me. (That’s how benign this process can be.)

Never had any GU, GI, ED, or bowel issues. Just another day…… I told my medical team that successful treatment and quality of life were equal priorities for me. (They aren’t mutually exclusive.) External radiation also leaves more salvage options should (heaven forbid!) I have a recurrence.

Last PSA was 0.366 ng/mL, which is great for still having a healthy prostate producing PSA at a new normal.

You get to define what “successful treatment and quality of life” means for you and then pick the appropriate treatment.

(What have you learned about SBRT, IMRT, and surgery that makes you lean towards one and away from others?)