Not necessarily.  I had a Gleason 7=3+4, PSA 4.5, T1c case at age 67.
My urologist suggested either surgery or radiation.   I chose surgery,
which he did.  But had I chosen radiation,  I'm sure he would have been
happy to refer me to a radiation oncologist.

In making the decision, you need to try to balance the likelihood of a
cure against the likelihood of side effects which might impact your life.

I chose surgery for a variety of reasons.   My urologist estimated that
with his doing the surger, at age 67, the likelihood of ending up
permanently impotent was about 50 percent.   I figured the odds of
impotence might be slightly lower with radiation, but since I hoped to
live at least another 20 years,  I felt that surgery had more reliable
data about recurrence and long time survival in cases like mine.   Still
it was a close thing.  Had I been five years older I would probably have
chosen radiation.   That is because for men over 70, the odds of
impotence after surgery go up rather quickly but for radiation not so
quickly.  At the same time, an older man has a shorter expected lifetime
and perhaps need not worry about reccurrence.

As it has turned out I have been PSA free for 6 years now, but I was
impotent for 18 months.  During that time I used a pump with reasonable
success, and my wife an I continued our sex life more or less as befre
surgery.

Perhaps some of these same considerations apply to you, but clearly the
breast cancer may change the situation significantly.  If I were you, I
would try to get as many opinions as possible and also try to get the
different physicians taking care of you to talk to oneanother about your
 case.

Yeah, we know guys get breast cancer.  Damn, Chuck!  That's a tough couple
of diagnoses in a short time.

We do have a couple of multiple cancer patients here and I'm sure they'll
jump in.  It is my recollection that they pretty much treat them as separate
cancers.

Your PSA is low (even with Proscar).  You did not mention a Stage or
Gleason.  Assuming it is a Gleason of 7 or less and Stage 2 or less, if your
body is in good shape, then surgery has the statistically best chance of a
cure.  However, if  your numbers are higher or you have the typical
68-year-old body, or your body is depleted due to your recent major surgery,
then radiation is not far from surgery when it comes to possibilities of a
cure.  Of course, those possibilities go down remakably if the Gleason is
higher and are relatively elminiated if the Stage is higher.

The good news is, prostate cancer is a slow-growing cancer and, generally,
the older one is, the slower it grows.

I wish I could say that it is the least of your cancer worries, but I'd have
to see those other two numbers before suggesting my nearly-useless,
non-medical opinion as such.

It's a tough decision. Brachytherapy does work. It's important to find a
good doctor no matter which procedure you decide to have. Brachy is easier
to undergo. It's done as a an outpatient in most hospitals especially if you
have someone at home to care for and wait on you for a few days as you
should remain a couch potato afterwards. Not everyone  is a candidate for
brachytherapy for a variety of reasons. Talk to several doctors. You don't
need to make an instant decision, but you don't want to waste time either.
Bev