Here's what you need to know about worst case scenarios
My husband died from prostate cancer, which they are now debating about screening for. He was young too; 65 when he died, 59 when diagnosed. Yes, he had a PSA test, and his PSA rose every year and they told him to wait. Then they told him to have a biopsy. They didn't find it on the biopsies for two more years, although he still had a rising PSA. The biopsies were cancer free until they weren't. When they weren't, he had a Gleason score of 7 on a scale of 1-10. The Gleason score doesn't tell you if the cancer has spread, but it does tell you how primitive it is, which means how aggressive and unlikely to be contained.
He had to have surgery with a score like that. We went to Mayo. When he had surgery, at the end of the operation the surgeon said it was left in one little lymph node. He admitted he didn't "get everything" and couldn't. But everything else was fine, and he recovered quickly.
At the time, I talked to a number of surgeons at the VA hospital, who see more of this than anyone else. I don't care what they say about robotic surgeons, etc. You have to talk to guys who have done massive numbers of cases. The guy at the VA hospital told me people with a Gleason 7 have 4-5 years, and to take advantage of them.
Gerry didn't want the surgery. He was a physician, and having diagnosed a lot of cancers, he thought it was more important to have quality of life. I convinced him to have it. Magical thinking: the surgical fix. Gerry spent time being incontinent, and of course impotent. He eventually got a penile implant (ego).
But we did live every moment and had a wonderful time. Until very near the end, he felt fine. He used to say to me, "for an old guy dying of cancer, I feel better than you do."
He went for all the treatments, hormones and everything, but it metastasized to his spine.
He died 4.5 years later. The guy at the VA was right.
That being said, things have improved for metastic PCA in the last ten years since he died. But be careful not to force your husband to go through too much. Let him make all the decisions. It is, after all, his life.