Lots to consider. mathew61 I didn't see where you mentioned your age.
QOL: Quality of Life is a significant consideration - but age may dictate different definitions for QOL.
For example: Those who have prostatectomies have a higher incidence of permanent Erectile Dysfunction. (permanent means not recoverable and not treatable by common meds.) So for some (I'll assume on the younger side), having erectile function would be very important. For some who can be open to change sexual intimacy can be had without intercourse.
Insurance (the bugaboo of US medecine can close some doors.
Lengthy treatments or treatments at distance are not possible for some according to the complexity of their lives.
With uncertain Prostate Cancer indicators, active waiting used to be an approach, but there is more use of Active Surveillance (might mean regular PSA's and intermittent biopsies ) treatment only when indicator indicate advancing disease.
The PSMA PET scan is a last three year development. Can mean first look diagnostic for PCa spread, but can also be used as a part of Active Surveillance if numbers change.

My own history: increasing PSA's over multiple years (like +~1 per year)
2019 PSA at 8.18 (but should have been doubled due to finasteride (BPH med).
Medium quality MRCI showing anterior (front) lesion (not detectable by Digital Rectal Exam.
Nov 2019 fusion (MRI and ultrasound guided) biopsy at Mayo Clinic Rochester showing Gleason 4+3. I was 69 years old.
I opted for PBT proton beam treatment at Mayo Rochester and had the five treatment protocol (including SpaceOar insertion) Jan/Feb 2020.
I started on flomax while under treatment and still take it daily to get good emptying of my bladder. Perhaps some irritation to my bowel - but seems ok with some modification in my eating habits.
I say that I am in remission and that I hope it stays that way for the rest of my life.
There is an urge (by some) to say "Get that sh_t out of me" but it is worth looking at the various treatment options (not always offered by urologist surgeons).

It may be worth saying that Prostate Cancer treatment is a moving target. 10 year old studies comparing side effects, recurrence, do not, typically, reflect the changes in the method of delivery that is currently available.

Checkout the resources of the Prostate Cancer Foundation (while ignoring their tepid comments about Proton Beam Treatment). The Prostate Cancer Research Institute has an amazing series of well presented videos available on YouTube.