18 year ago, my psa rose, I had a biopsy, cancer found gleeson score 5 or 6 (dispute among a number of my pathologist friends.)
There was no information on difference in cure rates (no recurrence in psa after 15 years) but there was great information on complication rates. I went for the modality with the lowest complications (radioactive seeds in the hands of an experienced operator.) I went to the most experienced operator in America in Seattle. (Since then the use of seeds has been modified and its even better just as surgery has improved. Radiotherapy is also more precise and some people --not me-- believe that proton therapy will prove to be best while others favor the gamma knife --but I digress.)
Had first to go to Seattle for measurements (Now I would do it all in Philly.) Came back to Seattle on a Friday night, had the seeds planted Saturday, came back Sunday for follow up X-rays, flew back to Philly Sunday early afternoon.
At workMonday (unpleasant burning sensation you know where.) Drove to NYC Wednesday to give a lecture. (Burning ass hole tolerable but unpleasant and lasted for weeks.)
The balance: no work missed,uncomfortable ass for a few weeks.
Now --18 years later:1) pants dry but at 76 years old need to go to the bathroom when I get the urge. Couldn't drive more than 90 minutes without needing to pee. 2) Erections on demand,multiple ones using Cialis. 3) PSA undetectable
Knowing what I now know, I would make the same choice.
Incidentally,the cure rates are still excellent for the three methods (surgery, external beam radio therapy and seeds) with data not yet available for longterm results of cyber knife and proton therapy BUT if one has the edge (and it is a tiny edge) the seeds are ever so slightly the most effective for long term "cure. This is using the seed therapy of at least 15 years ago, the surgery of at least15 years ago, and the external beam radiation of at least 15 years ago (the cure being no rise in psa after at least 15 years,) All in all the cure rates of all three run well into the mid to high 90% range in men without spread outside prostate capsule when diagnosed and treated.
Good luck. Hope all goes well.