Every professional I've consulted so far, from Urologist, Surgeon, Oncologist and specialist Nurses have all said the same thing.....decide what treatment you want with you heart and nothing else.
I have a friend who is going towards surgery whilst I am now on the HT/RT route. He wants his treatment up front and done in one go. He is happy to take the next twelve months getting over it and hopefully regaining continence and sexual function.
For me the research I've done seems to indicate a large percentage of complications are common during and post surgery, with infections, bleeding and urethra clip movement or failures. Of course most are successful and I am only reading about the abnormal cases, but having spoken to, and read about people who had surgery a lot said they might have not gone for it had they taken longer to think things through.
A lot of men rush into surgery because they are keen to lose the cancer and get things over with quickly. Choosing surgery for emotional reasons seems common. However what many are not told about is the chance that whilst the cancer cells may not have metastasised into the lymph nodes or bones some cells may have escaped into the surrounding tissues of the bladder, rectum or pelvic floor. Unless visible to the surgeon these will not be dealt with by surgery and will cause a 'Biochemical Failure' (or recurrence) in the following two to five years. That will mean returning for the HT/RT treatment that the candidate tried to avoid in the first place. My Oncologist puts that risk at about 25% for men with intermediate cancer (G7 4+3).
For me it just seems more scientific and logical to first starve the cancer cells by depriving them of the testosterone they are feeding on and the zap the little sods with RT or Brachytherapy which should also include a small spread to take care of any 'positive margin' that might be lying around the surrounding tissues. It's not fool proof and there is a similar chance that a recurrence could occur but it does seem that the chances are a little smaller.
One thing pushed to surgery candidates is that post RT salvage surgery won't be possible. Whilst that has been true in the past it's now becoming a little more common as RT becomes more accurate. So it's one more myth to debunk.
Post RT you also have Cryotherapy and High Intensity Focused Ultrasound technologies available along with good progress being made on the genetic research front especially using RNA. I believe only the delivery method is holding that up.
I would not urge anyone to go for my choice, or to go for surgery. It must be what appeals to you as an individual but the one thing I would say is to do your research and find out as much as possible about the path you favour before you choose. Too many are pushed towards surgery as a quick fix and as a one stop solution but it's not that simple.
The one thing I have found is that I can locate plenty of posts on forums saying 'I wish I hadn't rushed into surgery' but I can't find one that said 'I wish I'd never had Radio'.