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I was Gleason 6 pre. op. upgraded to 7 post op. Surgeon felt cancer was confined. I also was 58 and very healthy and physical. The surgeon found cancer got out of the prostate into the fatty tissue around organ. This caused some nerve damage to remove. Everything else was clear. After surgery my incontinence went away very quickly. About a week after catheter was removed I was 70% good. 100% after about a month. ED started getting better after a year. 1 1/2 years post surgery PSA started going up. Had salvage radiation and ADT therapy for 6 months. Radiation was easy with no complications. ADT was difficult. I stayed active but still gained weight and libido was totally gone. Mental ability was compromised. Hot flashes lasted 6 months after my treatment was over. 2 years later my libido and ED is just starting to come back although not as it was before ADT. I would have been very happy with my decision to have surgery if the cancer had been confined. Even though I tolerated ADT pretty good I hope I never have to go back on it. If I knew the cancer escaped I probably would have opted for radiation. But how do you know.
PSA is still undetectable. Good luck
As you said, it really is your call but let me share my experience with you. I was 57 when diagnosed (64 now), 3+4, T2B. I chose EBRT with 9 months Neo Adjuvicant ADHT. The reason for my choice was as follows;
- I was close to an 8 thus the chance of extra capsular penetration was high.
- I did not want to be incontinent nor impotent.
Bill my post treatment PSA's (March 2008) have all been in the order of 0.1 (+ or - 0.02). Radiation coupled with ADHT has certainly exceeded my expectations. My quality of life is excellent.