After consulting several urologists, I concluded that based on my age (73), Gleeson scores, confinement of my cancer within the prostate capsule, and the relative post-treatment side-effects of both options, that radiation was the best choice for me. I went back and forth on deciding between oth options. The tipping point was a conversation with a Mayo urologist and surgeon who put it this way (I'm paraphrasing.), "My father is your age. Either surgery or radiation is a good choice to attack the cancer. However, the possible complications from surgery -- ED, incontinence, etc. -- are more consequential in the near term and can contribute negatively to your lifestyle. Radiation consequences are apt to more consequential in the longer term. At 73 or older, there's a good statistical likelihood that another disease or medical malady is going to enter your life in the not too far distant future. Do you want to suffer with surgical post-effects from prostate removal only to be hit from the side by another medical dilemma? Why suffer more than you need to." Put simply, for me it was a trade off between "pay now or pay later." I chose the former. Your calculus may be different, keeping in mind that the long term survivability rates for both treatments are effectively the same.