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Some diagnosed patients with lower to medium grade prostate cancer are more concerned with giving themselves the best chance of a cure/survival and are willing to take a chance on unwanted side effects. Others may want to be cured but are willing to take a bit of a chance on treatment in order to preserve their sex life and/or continence. Once you've established to yourself just where your priorities lie it is a much easier decision to make. Prostate removal obviously offers the greatest degree of potential cure but it has more side effects. Radiation and Brachy (radiation seeds ) are growingly effective also with some but potentially fewer side effects. Watchful waiting is cumbersome and pretty much "wishing and hoping" in my non medical opinion...but 'many' choose to do it and it works out for 'some'. Each patient has to come to grips with his own personal priority.
Having the prostate removed is not a cure all. We produce testosterone in other parts of our body which fuel the cancer. But as you and many others know that it is different for all of us. Removing prostate and testicles is not as widely used since the hormone treatment came around.