Nice job on the signature.
I had robotic laparoscopic surgery (RLP) and am very happy with the procedure. It was much easier than the two hernia surgeries I've had over the years. The pain was minimal for me and recovery went very smoothly.
At 59 and in good health, there are many treatment options that can make sense for your brother. Please review the second fixed topic at the top of the Prostate Cancer forum page for links to treatment info. There are many links to various treatment options that you may choose to review.
/* Disclaimer: the following is not medical advice, just for discussion */
Each treatment has pros and cons in terms of side effects. There is not much data on whether surgery or radiation is more effective in eradicating the cancer. What we do know is that 95% of those who catch and treat prostate cancer early have a 10+ year survival rate. Almost all treatments have side effects causing incontinence, either urinary or stool incontinence. In addition, surgery often ends up in some form of E.D.
Some men who have a higher Gleason score, such as your brother has, have preferred radiation over surgery to irradiate not only the prostate, but some of the surrounding tissue to help ensure that any cancer that may have escaped the prostate has been killed.
If the cancer is contained in the prostate, then surgery has been called "the gold standard." This is because surgery removing the entire prostate has a chance to remove all prostate cancer from your body.
If your brother does have surgery, a post-operative pathology is done on the prostate which can give him a pretty good indication of whether or not the cancer has spread beyond the prostate. This is not possible with radiation treatment that "kill" the prostate. Again, you hope with radiation treatments that not only do you kill any contained cancer, but also any that may have traveled near the edges of the prostate.
The good news is that he has caught the cancer with no detected spreading thus far. Now he should find a decision that he is comfortable with.
You're a good sister.
Keep asking those questions.