My PSA Is 18.67, Deciding Treatment

thursday, i went to meet with my radio onc. he told me that i was his most knowledgeable patient in the area of PCa he's had in a long time. i attribute that to all of you who've been a huge help to me. so, anyhow, i went to discuss radiation therapy in more detail, esp. after i told him john epstein downgraded my PSA to low grade G6, plus the bone scan showed no evidence of spreading. based off of that information we discussed whether or not i should do either AS or brachtherapy alone. once he found out i hadn't been tested for my PSA since last year, he wanted to order another PSA and told me that if it's like a 20, he'd suggest hormone therapy along with radiation.

well, he call'd me back, with the results, he says my PSA 18.67 and bein' this high is cause to put me in the unfavorable intermediate risk category. he recommends a one time injection of eligard, in combination with external beam and possibly brachy-therapy. he said he will talk with some other urologists about my situation to make sure everyone is on the same page. i'm supposed to get back with him wednesday. what do you guys think of eligard? i'm feeling down and sad.

what type of impact will this have on my overall prognosis?

should i consider surgery instead?

is the cancer getting worse, because of no treatment just yet? i have no idea what to think. what R your thoughts? i'm scared U guys.

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D.O.B. 1973
07/14 PSA 5.5 
08/14 TRUS Bx Prostatitis & BPH
07/15 PSA 5.9
01/16 PSA 7.6
03/16 PSA 6.2 
07/16 PSA 6.9
10/16 PSA 6.9
03/17 PSA 7.2 
05/17 3T MRI Good
11/17 PSA 7.7
11/18 PSA 10.8 Cipro for 2 wks
07/18 PSA 11.9
08/18 3T MRI: 3 per ZN focal ABN, 1 with a PI-RADS 4 lesion & 2 with PI-RADS 3 lesions. No extra PCa disease, pelvic LAD, or pelvic lesions
02/19 MRI fusion biopsy
Bx Findings
A. PROSTATE, LESION 1, LEFT APEX, 3D MRI FUSION BIOPSIES: * BENIGN
B. LESION 2, RIGHT MID GLAND *PCa, GS 4+3=7 (GRADE GRP 3) 3 OF 3 CORES
(95% DISCONTINUOUS, <5%, <5%) * GS GRADE 4 60% OF THE TUMOR
0 PERINEURAL INVASION IS PRESENT
INFLAMMATION.
C. LESION 3, DIFFUSE LEFT MID GLAND, 3D MRI FUSION NEEDLE CORE BX's
PCa, GS 3+4=7 (GRADE GRP. 2) LESS THAN 5% OF THE FRAGMENTED CORES
GS GRADE 4 INVOLVES 5% OF THE TUMOR
2nd Bx OPINION
A. Benign
B. PCa, GS 3+3=6 (Grade Grp. 1) 80% of 1 core 
C. PCa, GS 3+3=6 (Grade Grp. 1) 20% of 1 core
Considering options