@jlhiggins01
Sadly we welcome you to the P.C. group. I had the same Gleason score as you. I chose 30 rounds of proton. I was 76 at the time. You are only 54 and that age difference is significant in the difference where medical doctors give recommendation, prognosis, etc. and look at long range side affects.

I don't see where you mentioned a Decipher test, PSMA, type test. Did you have these. Those really help your medical doctors make recommendations. If you have not had them asked your doctors about them.

I make that recommendations not from a watching a seminar as I had those test so can give you personal experience. I was original schedule to have radiation and hormone treatment. After got the Decipher it came back low risk. They changed (two different medical institutions C.O.E.s said identical diagnosis and treatment plan) my treatment plan to radiation only.

Thus can suggest because of personal experience and how much the Decipher test affected me personally would suggestion if you have not gotten it talk to your doctors about getting one.

Those that have had a prosectomy could better guide you on that procedure and the side affects. But know that what another one side affects were does not mean you will have them or not have them. It is an individual thing based on you, your body, your surgeon, and where your have the sugery and the expertise of that institution and surgeon.

I had radiation proton. Talk to your urlogist or R/O about proton and photon differences as they are quite different. Basically you are worried about secondary damage to other organs and tissues. Know that having photon radiation means the radiation enters your body and exit your body thus everything at entry, in, and out of the body is radiated.

Proton is much different. It can enter the body at a lower dose, release it full radiation at a specific location and stop. It dose not continue and exit the body. My R/Os, and PCP all stated this as the major difference in the radiation. The successfulness of both are identical. This is not my opinion nor inferring I am giving medical advise or something I got from a seminar but from my Mayo PCP, urologist, and two different R/Os. All stated studies and their own research with thier patients treated. Proton was consider a less chance of secondary radiation damage. All stated long term research is being done so they are passing on their individual research they know and directly experience with thousands of their patients.

One R/O has done thousands of proton radiations since 2006. Long range research will give difference in those treatments and side affects and damage of each. But your doctors (if have extensive experience with treating P.C.) can give you like mine did their direct personal experience of what they have seen treating P.C. patients.

When you get responses pay attention to those who have had the personal experience with the diagnosis similarity, age, treatment options, and what they had to give you personal experience close to yours. Not just a study, research, seminar, etc. The personal experience of others to share is the reason M.C.C. was started.

Good luck on whatever treatment plan you chose. Just know surgery is surgery and your will be having your prostate remove totally. With any surgery there will be side affects, and they can be minor or serious. It depends on patient, their body, and the expertise of your surgeon and institutions.

If you want more information from a C.O.E. institution contact UFHPTI and asked for their handout. It is free, not pressure to do there. It will give you tons of information and research about photon and proton radiation and the two books every one talks about (one is the Walsh book). That can along with consultations with your urologist, R/Os can help you decide questions to ask your urologist, surgeon, or R/Os.

Good luck and again and hope you have a successful treatment no matter what you chose. But chose what is best for you not what another chose.