After my diagnosis in November 2023, we looked into both robotic surgery and radiation. My urologist only suggested surgery but I needed more information and we went to work, We consulted with multiple highly regarded cancer centers and were given quite a bit of information, but also confusing information. Based on our research, my wife (a nurse) and I took surgery out of the equation for a few reasons. Long-term data suggested similar long-term outcomes and we focused on "least invasive" and "least chance for collateral damage". We learned about the differences between Photon and Proton radiation. We were given some confusing treatment plans: start with ADT, or not; ADT after radiation, or not, and asked, what would you like to do? This was both confusing and actually extremely frustrating. At the last center, a treatment plan was proposed and we directly asked the doctor "what would you do if this was your father" and received a direct answer. HE firmly stated this is the treatment he would suggest for his dad and for himself! We decided then that this was the cancer center where I would receive treatment.
I chose to get Proton radiation based on what we learned about how it is more focused and does not radiate extraneous areas of the body (it stops at the target point). After my 29 treatments, I started taking Orgovyx, which was no fun, but necessary per my trusted physician. My initial Gleason scores were 4+3 and 3+4, contained to my prostate. My most recent PSA was 0.02 and testosterone < 12 which is what they need to see - I so miss the testosterone!