if you are healthy then I might suggest surgery then the other two. Though I would not be any more correct than anybody else. I have read that those with high risk disease do better if the prostate is removed than not. My understanding is that most cases where the disease is hormone refractory, not responding to the hormone therapy, has the refraction begin in the prostate most often. But I certainly can see HT then RT within a month. Good luck in your decision. You are a good candidate to read a book by Snuffy Myers "Beating Prostate Cancer: Hormonal Therapy and Diet. You might want to get it before your decision as it specifically speaks to your situation.
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
My PSA did drop out after surgery to undetectable. It has not returned and I will continue HT until January '08.
My Life is supported very well by family and friends like you all.