Decided to go the treatment route, took me a while but AS is no good mentally, PSA has crept up from 4.2 to 5.1 in 18 months, awaiting appt date with oncologist.Presumably SBRT as per discussion when diagnosed in autumn '22, will be at Christies Manchester.
Will keep folk posted.
Removal of the offending gland is a no no for me, not so much the ED issue more with regards to incontinence.
Feel like a weight has dropped from my shoulders, may regret it in years to come due to possible side effects but worry about that if and when it happens.
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pd63
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Being low risk intermediate, gleason 3+4/cpg2 oncologist said ADT wasn't warranted particularly as I've stroke history 6 yrs ago (possibly Afib related), when diagnosed urologist wanted me on 6 months ADT, seems to be SOC for all UK intermediate risk, but previous studies don't support this.
SBRT should be easy for you. Narrow margins and no ADT. My best advice is to exercise as much as possible. Good oxygenation is important for killing the cancer, and keeping healthy tissues healthy.
Cardiovascular disease runs in the family anyway so future possible treatments hopefully not needed could be an issue.The old man had a couple of tias and quadruple bypass during his treatment for pc back in the 1990s, can't remember what therapy he had and he wasn't one for divulging much, whether the treatment caused or exacerbated his CVD is history now.
Fortunately my afib is low burden and had full recovery from stroke returned to work after 4 weeks, when I was cleared for driving.
No other comorbidities swim 2000m 4 times a week and can still hike up big hills, it's just this f**king cancer
I know how tough going from AS to treatment is as a decision. I first found out about my PCa . My GS was originally 3+3=6 and it increased to 3×4=7 the following year. My PSA was about 6 when my doc sent me to a Urol in July 2015 and I stayed on AS until my PSA hit 19.3 and I agreed to treatment in July 2021..SBRT. which seems to have worked well so far .My last PSA in December was .57.I did refuse any ADT as part of treatment plan...I was 81 at the time with heart disease..and my RO had no objection to it.
I know each of our cases is different but I just offer my story because th PSA you have on which you are deciding to get treatment seems sort of low to me. With timely followup testing and a good RO you might have a lot more years of AS before you need treatment. I was fortunate that I have had almost no side effects other than some fatigue and a little slowness in urinating from time to time. I took Flomax for awhile but haven't needed it for well over a year.
I had Urologist recommending treatment to me when my PSA got to 10% back in Dec 2018 but my follow up MRIs convinced me to stay on AS until 2021.
Anyway best of luck to you. None of these decisions are easy but when you make them yourself with help from fellow patients like those on this forum it's the best you can do
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My decision on Radiotherapy -v- Prostatectomy
Decision Time
Making a decision! 
Fatigue BEFORE treatment (A bit of a rant) 
