That depends on many factors, including your location, age, the results of biopsies, PSA levels, and your general health. And expert opinions do differ, but get them anyway, and weigh them up very carefully before making any decision.
Radiation therapy (and there are various kinds, including brachytherapy) can be very successful for some patients, meaning the tumour cells are killed off while the prostate is kept intact (though there are sometimes unpleasant side-effects, such as rectal inflammation, while the therapy is undertaken and thereafter). But for those whose tumours reappear later, even after some years, the possibility of successful surgery then is frankly quite low.
Bear in mind that repeated radiation is not possible in the long term, and it must be pointed out that ultimate success with radiation therapy is currently not much over 50–70% even with improved techniques. By contrast, with a radical prostatectomy, although radical by definition, the success rate in removing tumour and preventing recurrence is commonly over 80%. If you feel lucky or confident about your chances, then radiation therapy may well be for you, but think about it and weigh up the options carefully.
If you decide to watch and wait, make sure you have regular check-ups to see if the situation is changing, and if so, to what extent. If cancer is present, it can stay dormant, grow slowly or accelerate rapidly, for reasons that are not yet fully understood.
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