Robo, there is a lot of great advice previously mentioned. Given your relatively young age of 64 and being healthy, I would lean toward a more aggressive treatment plan. For me, active surveillance would off the table. When I was diagnosed with PC last September, I was praying the biopsy would come back 3/3. Fortunately, my prostate cancer was confined to the prostate (as far as any doctor can say), but Gleason Score was 4/3. I elected for surgery because I wanted the best chance for 30+ years of prostate cancer free life (obviously, no treatment will guarantee this outcome). Surgery allows for a complete biopsy of the prostate, seminal vesicles, and any lymph nodes that were removed. For myself, this was very important. I did not want to rely on imperfect imaging tools and biopsies to direct the treatment. Rather, I wanted to remove all known cancer from my body and have the margins physically defined. Also, given my age (56), I did not want to deal with the potential side effects of radiation and the inability/difficulty to perform a radical prostatectomy after radiation. For myself, the surgery was not that bad, with the worse part being the 1 week long catheter experience and the referred shoulder pain that lasted about a week. Outcome for me - Cancer confined to prostate, PSA undetectable 1 year out from surgery (praying this will continue for 30 more years). With surgery or any other treatment plan, you definitely want to go to a center of excellence - Your quality of life, for the rest of your life, will depend on the competence of the surgeon/oncologist/...

I agree with the other posts, don't let anyone tell you there is only one treatment plan. Every man and his situation is unique and you need to make the decision for your personal life expectations.

Best of luck with your decision.

Have a merry Christmas and a happy/healthy new year!!

Jim