Posted 6/3/2021 5:02 AM (GMT -6)
chad, surgeons generally are more aggressive at their sales pitch. I bet you heard "If surgery fails you can have radiation later, but if you have radiation first, you can't have surgery later".
You're low to low-intermediate risk with the smidgen of G4. The issue for those of us in the category are the side effect profile and the impact treatment will have on our immediate lives. In your case, you chance of a cure with SBRT (5 treatments) or IMRT (usually 40 or so treatments) is approaching 100%, so worrying about failure is really, really low on the list.
Surgery is also likely to be curative, you'll have a defined final pathology, and you'll have nearly immediate cancer control results: your PSA will go to zero within a few weeks. Downside is that you'll wear a foley catheter for a week or so, you'll have the surgical injury to recover from (it takes a lot longer than you think it should), and you've got a non-zero risk of incontinence and ED for at least the short term, and up to a year or more or forever.
I'm a surgery patient, 6+ years of non-detectable PSA, no definable incontinence, and no ED with a little help from Cialis.