Welcome to our corner of the world - sorry you need to be here but it's a great place to be.
How do you decide? That the tough question here but with your numbers surgery, seeds, or beam radiation will all likely work just fine. The side effects vary and the effectiveness of each can be argued. In the end it comes done to a numbers game where you try to pick the most effective treatment with the least side effects based on probabilities and a lot of guess work.
As to the suggestion you get HT and radiation now - that seems excessive for a G7. A more common approach at your stage would be to do one treatment and wait to see what happens to the PSA. Then only if there are signs the treatment failed would you move on to the next treatment. You would on really consider HT if the cancer has escaped the prostate bed.
At this point you really need to learn more and you should really get a second or third opinion before deciding. You might also want to consider reading some of the great books out there. Dr. Walsh's book, "Surviving Prostate Cancer" is a good place to start.
In your case I'd think the choice for a first treatment would come down to either surgery or radiation (beam or seeds do about
the same). The difference is really in side effects. With surgery you wake up with side effects like incontinence and ED but with radiation the bowel symptoms and ED can take longer to show up. Take a look at some of the recent threads on this site where we've listed the different effects of our primary treatments for some first hand accounts of what could happen.
So I'll ask you this question, "what is your gut feeling on what you want to do?" What treatment would you feel most comfortable with. You strong and fit so you'll do fine with either treatment.
Sorry for not being able to give you a scientific method but there's no clear cut best way. That one of the many things that is difficult about
this PC - so much is uncertain and all we can do is take our best shot and hope it works.
All the best,
I'll be in the shop.
PSA 4.2 10/11, 1.9 6/12, 1.2 12/12
2 out of 14 cores positive
Treatment IGRT - 2/2012My PC blog