@jeffmarc my dad had a radical prostatectomy at my age (63) so I know I am in a high risk category. At this point I will pursue a biopsy asap and hope the EPE is only threatened. Definitely a stressful time but I appreciate your response.

@jeffmarc Hi Jeff, thanks as always for your involvement and advice. I wanted to ask you your thoughts on SBRT vs RARP at my age of 68. My history is below as you likely read at some point over the past few months. *Can you give me your thoughts on treatment choices since my priorities are: Cure, Continence and Sexual Health. I do have a RARP surgeon consult tomorrow and have already had the RO consult who said SBRT without ADT now, and then if recurrence happens, then brachytherapy. See my history below and please advise from your vast experiences: Pathology Picture post MRI & Fusion Biopsy
PSA last three years were: 13.3, 16.6, 12, and 10.8 most recently
Grade Group 2 (Gleason 3+4=7)
7 of 15 cores positive, <10% volume
Bilateral disease
Pattern 4: 6–10% overall in systematic cores; ≤5% in targeted cores
<5% Cribriform glands: present
Intraductal carcinoma (IDC/IDC-P): not identified
Maximum reported core involvement: 21–30%
Seminal-vesicle invasion: not assessable on biopsy
MRI: PI-RADS 5 right anterior transition-zone lesion
MRI: “Likely involvement of AFS”, but no definite EPE stated
MRI: no seminal-vesicle involvement, enlarged pelvic nodes, or suspicious bone lesions
THOUGHTS regarding treatment? I want to be cured but surgery does scare me somewhat...