So I asked the Radiation Oncologist about the long term threat that the radiation cancer treatment might give me cancer in the future. His response was interesting and not something I'd heard before.
Basically (and this is simplified from what I'm sure was a dumbed down answer), while there is a risk that radiation treatment can cause cancer in the future, it's low.
The general opinion is that there's about a 5% chance of consequent bowel or bladder cancer within about five years post RT. It seems to be linked to the amount of spread outside the prostate capsule that the machine is set to give. The less accurate the focus, the more collateral damage done to surrounding tissue. Some spread is desirable in top end intermediate or high risk cancer to mop up any positive margin of cells that may have leaked out. To put it in context the best machines usually operate up to 5mm of spread with stereotactic machines like Cyberknife operating down to 0.5mm. That's great if you know all the cancer is in one place and in the centre of the prostate but if (like me) there's some lurking near the edge it's best to have a general blast around.
This equals the same 5% chance of never regaining continence post surgery.
The one thing all my research has shown so far is that there is no easy ride through prostate treatment. You have a choice of two lousy journeys. You just choose which is most palatable to you.
I had to use Tamsulosin prior to the transperrenial biopsy. Apart from making me feel lousy and aiding flow rate it didn't seem to have any effect on frequency or sexual activity. Despite the side effects in the leaflets, every man is different.