Dave, Robotic prosectomy would be my choice. That was my option 9 years ago and even though I'm still a cancer patient its being managed fairly well. I was 69 at the time of the surgery. Make sure you have a surgeon who is very experienced at this type of Robotic surgery. My Gleason had a couple of 8's and a 9. The surgery did not, even though the margins and glands tested to be clear following surgery, get all the cancer. I do have residual microscopic cancer but kept in control mainly with quarterly Lupron injections. After my surgery I did have radiation and Chemo but my PSA never went to zero. Incontinence never a real issue, ED somewhat of a problem until I started Lupron about three years ago. My testosterone is now less than 5 so no sex drive at all. I'm now 78. The processes today have been refined and I believe more effective but of course no guarantee. I'm in good health today with no other serious issues but still always concerned that my next visit may not be favorable. I visit my oncologist quarterly and PSA has been less than 1 for last two years. I do get occasional scans and MRI's. Whatever you do make your best effort to keep your body in good shape and visit with a nutritionist to get recommended foods to eat. Glad to answer any other question you may have.