Radiation and surgery are about equally effective in terms of overall and progression-free survival for early-stage prostate cancer. Neither offers a 100% guarantee, and each has pros and cons.

For advanced-stage prostate cancer, radiation is the only option, because they *know* that the cancer is no longer contained entirely in the prostate.

On the personal side, in October I'll have been 5 years in deep remission (no evidence of disease) with stage 4b oligometastatic prostate cancer. I had 20 gy of radiation to my spinal metastasis and 60 gy to my prostate, and have been on ADT and Erleada continuously since 2021.