I’ve got conflicting treatment recommendations. What is it like after surgery vs radiation therapy? And how long do the bad side effects last?

I was diagnosed with prostate cancer 30/11/25. My Gleeson score was 9 in Oct 2025. My PSA has been rising steadily by 3.0 every 6 months since March 2025. My current PSA 10.5.

My urologist scored my prostate cancer at cT3a. He referred me on to a radiation oncologist and PET scan.

The radiation oncologist revised by score to cT2c after reviewing PET scan report. He recommended starting ADT by end of the month, EBRT for 4 weeks 2-3 weeks later, with 2 years ADT afterward.

I got a second opinion last week from a Prof in Urology. He strongly recommends a radical proctectomy with 3-4 months ADT beforehand, He notes follow-up radiation therapy / ADT may be necessary if cancer has spread to lymph nodes, but said side effects are manageable. Less likely to be permanently incontinent than radiation therapy, with better chance of being cured.

I am waiting a written report from second opinion. I’ll ask the radiation oncologist to respond to the second opinion report next week.

I intend to start ADT in a fortnight. A decision will have to be made soon after that. Wish me luck.