SCJ428, glad to see you are reaching out for advice and doing your research. I did the same when I was diagnosed last year. I was 56 when diagnosed with Prostate cancer (Gleason 7 --> 4/3) in September 2022 and had a radical prostatectomy in November 2022 at Mayo-Rochester. I did a lot of online research, talked with doctors, and discussed with people who had went through prostate cancer treatment previously. As others have stated, it is a personal decision and has to align with your life expectations. For myself, I decided on a radical prostatectomy. Given my age and hope for 30+ more years of cancer free life, I saw surgery as the only logical option for me. A radical prostatectomy is the only treatment that allows for all of the known cancer to be removed from your body and a complete pathology to be performed. Others options use imperfect sampling techniques (biopsies) and imaging tools to guide the treatment. For myself, I was unwilling to take the chance of missing existing cancer cells. As always, cancer is tricky and even if you remove the prostate, seminal vesicles, and several lymph nodes, metastasis could have still occurred. However, I saw a RP as the best possible chance for long term survival.

For me, surgery went well - Negative margins, lymph nodes clear, continence/erectile function regained. The biggest inconvenience of the surgical procedure related to referred shoulder pain from the inserted gas and catheter. It took about one week for the shoulder pain to go away and catheter was thankfully removed after one week.

Good luck with your decision and don't let anyone tell you there is only one treatment plan - Do you research, pick a center of excellence, and go with the best doctor at the center of excellence (preferably has done thousands of whatever procedure your decide on).

Jim