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Like you, once I had heard the "C" word, watch and wait was not an option for me. Cancer runs in my father's family, and Dad had prostate cancer.
I finally narrowed treatment options down to three: IGRT (Image Guided Radiation Therapy), brachytherapy, or radical prostatectomy. Because cancer runs in my family and because radiation treatment would make surgical solutions to any future cancer in the lower abdomen difficult if not impossible, radical prostatectomy seemed to be the best choice at this time. Once we knew we were doing RP,we went looking for the best da Vinci surgeon we could find in a reasonable travel and found Luis Anglo here in St. Louis who did 300 tradition open procedures before moving over to the da Vinci robot, where he has done over 500 surgeries, now including mine.
I can't give you a recommendation of what the "best" answer is in your case. Ultimately we are left to make very personal decisions on how to treat our cancer. Continue to research, read, talk, and get recommendations. Hold out until you are absolutely satisfied that you have the best solution possible at the time. And then be at peace with your decision.
I'm currently doing the Hormone therapy and Radiation treatments. I was 48 yo when I was diagnoised in September of 2008 and had a PSA of 158. Seven months ago I had a Radical performed in which they took the prostate, both seminal visicles, and over 40+ lymph nodes. The Radiation and Hormone therapy that I'm currently doing is a clean up that I opted to go with. As far the sex life and incontinence good luck. I know each person is different, so remember no one will be able to predict your true out come. Read and educate your self that will hopefully help you make a better well informed decision. I just wanted to pass along my situation, that I'm currently dealing with. Reading others experiences has helped, but I've found that each person is different and especially when you bring in the Doctors.
My cancer was a T4 grade with spread to the seminal vesicles and pelvic floor. I was very lucky though, in that there was no spread to bones or lymph nodes. I had HT plus 37 RT treatments in 2005 and it seems to have been very successful. Here's the link to the story so far...
Whatever you decide, may I wish you the very best of luck.