Being that he has had several surgeries and his age I would avoid surgeries and choose the radiation. I had 44 proton treatments at Mayo in Scottsdale, with the 6 month Eligard shot and no SpaceOAR. There is a new alternative to the Eligard shot which is a pill with much less side effects. I am 79 and my urologist told me that his experience with surgeries and older people hasn’t been too good. My GS was 7(3+4). I also had a Decifer genetics test that was worthwhile. Good luck in choosing. Jim