I received an ablation treatment known as Irreversible Electroporation (IRE). Here is some info from my experience:

1) If you’ve had a biopsy, request a decipher test on the tissue from your biopsy. This is a step beyond the Gleason score and helps determine how aggressive your cancer is.

2) Give thought to getting a second opinion from a Cancer Center of Excellence. Here's a link:
https://www.cancer.gov/research/infrastructure/cancer-centers/find
3) If your tumor(s) are contained within the prostate, focal treatment is something to look in to. These treatments use a variety of ways to ablate (kill) the tumor(s) without removal or radiation. Look up things like HIFU, cryotherapy, Irreversible Electroporation (IRE), and others.
https://www.medicalnewstoday.com/articles/focal-therapy-for-prostate-cancer
My PSA score that got the urologist's attention was 4.25. A follow-up MRI indicated two tumors, both contained within the prostate, and both with a PI-RADS of 4. My biopsy showed a Gleason score of 3+4=7 (intermediate risk, favorable) and my decipher results indicated low risk, making me a candidate for active surveillance or focal therapy. I chose focal treatment because one of the tumors was abutting the edge of the prostate. I had the IRE treatment in January 2024 at the Moffitt Cancer Center in Tampa. After the treatment, I had some relatively mild incontinence which has mostly cleared up. I also had some blood in my urine for about six weeks after the treatment, but that has totally cleared up. My sexual function is unchanged from before the treatment.

In August, my PSA was down to 1.95. The follow up multiparametric MRI (mpMRI), done the same day, showed “post ablation changes of the prostate with no new recurrent tumor in the treatment area and no new suspicious lesions in the prostate”. My doctor said that later, if there is an indication that cancer has returned, I can consider an addition IRE treatment, removal or radiation.

Focal treatment is definitely not for everyone, but with the proper set of circumstances, it would be an alternative worth considering.

Best wishes for a great outcome for whatever treatment you decide upon.