Posted 2/8/2020 1:08 PM (GMT -6)
The others have already given you a lot of good advice, so I will simply speak from my own experience.
I was 68 at diagnosis, having had gently rising PSA for some years. When mine hit 5.69, I had a 12-core template biopsy, which showed 3 cores with low percentage of 3+3, and one core with low percentage of 3+4. With "only" one core at 3+4, I may have been able to go the AS route, but decided that for me, any grade 4 cells meant I should/would treat.
I did a lot of research, mostly about my treatment options (and there were quite a few of them), but also about the immediate impact of each treatment and their side effects. The immediate impact of surgery drove me to choosing radiation, as I had already had several significant surgeries and my cardio and I felt that another would bring too much risk. That decided, I researched the efficacy of various radiation therapies, where they were offered, how they would impact life during treatment, and, most importantly, their known side effects. Ultimately, I found that a couple of radiation methods would have similar efficacy, so I chose my ultimate treatment based upon its side effects.
I won't bore you with "what" I chose, or the specifics of what was important to me, as your situation will be your own. I am only counseling you about "how" I chose my path. I can go into a lot more detail if you want, but just the thought about there being several valid treatment choices for your Gleason score, and that you may be able to choose based upon side/after effects is what I wanted to impart.