@oldoz doctors have a natural bias towards doing procedures that they have had success with and are used to doing. They are dedicated but not infallible. You are clearly considering Mayo in Arizona which is great but being in a small town does not limit you from sending any blood work, imaging, biopsy report and any genomic testing, i.e. Decipher test, to a center of excellence and have a zoom consultation. It is done all the time.

I had a 3+4 Gleason with a PSA of 10.2. I did not want to wait for it to grow and potentially cause more severe treatment and side effect problems. I had 5 hypo-fractional treatments with the mridian linac radiation machine with has a built in mri so its all real time treatment. What the radiation oncologist sees is what they treat vs other forms of radiation machines that use fused images. Secondly, many of the radiation treatments involve treating the entire prostate PLUS extra space, called margins. The margins with the mridian were 2mm instead of 3-5 mm with other types of radiation machines. This meant potentially greater side effects. Google the Mirage randomized trial.

There are many choices that people have made successfully on this web site, including removal and partial removal, which is comforting to know. My decisions were made on my definition of cure, side effects and quality of life in the short, medium and long term. Good luck.