Best Prostate Cancer Treatment Options If You Have BPH Symptoms?

I've been on active surveillance for two years. I also have some BPH-like symptoms and take Flomax for it. I may need to get treatment for the cancer. I do a biopsy next month.

I'm Gleason 3+3, 1 core positive, PSA under 4, low Decipher, but there's a chance it has worsened. The MRI showed the lesion is larger and my BPH symptoms have gotten slightly worse. Prostate size 66 cc.

In the event I do need treatment, I know surgery would address both the cancer and BPH symptoms, but am very reluctant to go that route because of the higher incidence of incontinence as compared to radiation.

But if I go with one of the radiation options, such as SBRT, IMRT, brachytherapy, or Proton, I'm worried that it will worsen the BPH like symptoms. And if it does, what do people do? Of course, there's also the possibility that the symptoms could improve, but it is my understanding that is difficult to count on happening with radiation.

Thoughts from those who had BPH like symptoms when they went into radiation treatment?