I opted for high-dose brachytherapy. Two days of out-patient treatment a week apart. Although the procedure sounds pretty nasty, you are knocked out for it all. I had no pain ever with the procedure. I went home from the hospital (Mayo Rochester) driven by family members and took a long walk. My cancer likely started in my early 60's. My PSA was at 5.48 in 2017. A biopsy was recommended but then some health care dispute in my city caused a loss of nearly all urologists (many quit and others were fired, and leaving the city without urologists due to noncompete clauses). So, I did nothing. In Dec 2021 PSA at 7.8 sent me to an MRI, with 4 lesions at PI-RADS 5, 4, 3, 3. Did biopsy May 2022. Cancer found in 13 of 18 cores, two with PNI, most at 3+4. Surgery or radiation after talking to three doctors (my urologist, a surgeon, and a radiologist). Aug 2022 Decipher test at 0.42 (high end of low risk). I decided to wait and see. Dec 2022 PSA at 10.7. Second MRI Mar 2023 showed substantial growth of lesion pushing on capsule. Had two sessions of HDR brachy in April 2023 (16+17 needles) at Mayo Rochester at age 70. No issues. The procedure is not at all worth the worry. It is true that "Worrying is like paying a debt you don't owe." -- Mark Twain.