74 yoa here in good shape. Two 8 Gleasons and two 9’s so I graded “high risk.” Consulted with a surgeon and radiologist at Mayo and my local urologist who did the original biopsy. I chose surgery because of my scores and because all three said that if radiology didn’t work, then surgery after it would be very difficult if not impossible. I figured let’s take our best shot and leave as many options on the table as possible if something shows up later. Had MRIs, nuclear bone scan, and PET scan prior to surgery, all of which showed nothing outside of prostate. Surgeon removed 13 lymph nodes, seminal vessels, and vans. All of them were clear as were bladder margins, etc. I’m six weeks out from surgery and slowly regaining continence. I can live with a liner in my briefs better than I can cancer in my body but that’s just my thinking. May not be for everyone. You’ll have to make your own call. Prayers for you and yours as you decide and for peace and full recovery🙏