The more I read on this forum, the more I am leaning towards no treatment of ANY KIND. Radical Prostatectomy is major, life altering surgery with serious life changing quality of life issues, Radiation almost as bad, and hormones and ADT, good God, destroy the man just to keep him alive. I am 70 years old diagnosed 2 months ago with Gleason 4+3= 7 w/ 70% in 6 of 23 cores, 3 cores had Gleason 3+4=7 w/ 40% I had Pirads 4 pm MRI w/ 12 mm lesion ( volume .42cc) my prostate is 50.4 cc so low volume tumor, I had PSMA PET showing nothing outside the prostate, and my Decipher score was 0.38 Low Risk of Metastasis, so it showed 3.4% risk of met at 10 years ans 3.4% risk of mortality at 15 years, average lifespan for men is 82 or less. Granted, that is with standard of care treatment. Risk with no treatment of any king increases your risk 100% so 6.8% big deal, I'll take those odds against ruining my life, I don't even want to have a catheter. I have done tons of research on all forms of treatment, including focal therapy, Hifu, Brachytherapy, Tulsa Pro, Cryotherapy, and they all have side effects. I have also done major research on the Ketogenic diet, intermittent fasting, and foods proven to fight prostste cancer, like cooked tomatos ( Lycopene) watched many You Tube videos with Dr. Thomas Seyfreid, Dr. William Li ( food as medecine) Dr. Ken Berry and many others. Glucose feeds the cancer cells, so eliminate all sugar of any kind, vigorous exercise reduses Glutamine which is the other cancer cell fuel, I've been on this one month, lost 13 pounds, feel great, yes it is an extreme regiment and diet for this former carb lover, and food lover, but I'm willing to sacrafice that rather than take a chance of even 10% of lifelong ED or Incontinence and havong to wear a pad or diaper, also some treatments like radiation can damage the Rectum and affect your bowels, I don't care if that's a 2% chance, I'm not taking it. At some point, quality of life is more important to me than seeing how long I can survive. Prostate Cancer is big business, billions of dollars and the medical industrial comples is geared to treat, surgery, radiation, emasculating drugs, you name it, not many doctors recommend diet & exercise to fight low or mid grade cancer. I watched my Dad go thru it, and even if it metastasizes after 10 years, it's not the end of the world, and very few men actually die from prostate cance, look up the ProtecT study in the UK same survival rate at 15 years for intermediate PCa 1/3 of men RP, 1/3 of men Radiation and 1/3 no treatment just Active Surveillance. Think very hard before having any treatment, there is no rush, even the most aggressive form take a while to spread.