You do not have to make a decision by the end of this month. I say B.S. to any doc whom says so and would love to say face to face, you can be put on hormone therapy drugs, like casodex, lupron, zoladex, maybe avodart and others while you take the time to analyze your choices. This is the exact type of protocol used in the Bolla Study concept (by patients including myself whom had terrible stats and high risk level patient-I waited 5 months and psa went super low while waiting) and used often in conjuction with various types of radiations/combos and usually they advise waiting 5-6 months (4 minimum) before do radiations. These can be brachy seeds, brachy seed/combo's, various external radiations (IMRT-photon); Proton (Loma Linda et al); Neutron and neutron/photon is even available (only 2-3 places doing it).
Some folks have gone on casodex or its equals while deciding and waiting to do surgery or other protocols. NEVER should anyone be rushed into any treatment and you can get that info from the mostly knowledgable PCa docs like: Strum, Scholz, Barken, Meyers, and alot of others that know this beast from all angles... Alot of cashin on patients in the name of supposed medicine, some of these pushy docs don't run nomograms or other tests and other considerations that should be done...but would rather rush you into their 'curative' surgery-radiations-cyro-hifu-etc.....which comes with no guarantees anyway.
I know a guy whom did only ADT3(hormone) drugs for his PCa, low level case, 14 yrs. now and normal as a man, went 13 mos. on ADT3 quit and used only proscar as maintenance. This is not widely advertised (gee), has decent results...and Rick K. can still have surgery, radiation, HIFU, Cryo and other gigs. This same protocol has been used on higher level risk patients with favorable results, not considered a cure...buys time and choices and quality of life considerations and stops some docs from getting the latest Mercedes-Benz(lol).
Dx-2002 bpsa 46.6 12/12-biopsies all 75-95% PCa, Gleasons found 7,8,9's (2 sets about
the same), ct and bone scan found clear, started with emergency room for total urinary blockage, then to uro doc....and 8 opinions that followed and a path that is little different...cancer was a little different too, than the average presentation...lucky to be in the condition I am right now. (ADT3 prior like Bolla Study, then neutron & photon radiations* then ADT2*off drugs cycle* then started DES*off cycle and intermittent the last 4-5 yrs.)
Agree with John T. on cyberknife, if you go external radiation you need pelvic areas considered to help get to possible areas outside the capsule for best results and that is better done in other methods. The docs cannot know precisely where all PCa cells are-PERIOD. (risk-rewards scenario)