As I've mentioned in other threads, in many ways a borderline prostate-cancer diagnosis seems much harder to deal with than an advanced one. If you have Gleason 9 and/or metastases, you don't have to waste much time thinking about what to do: the answer is more-or-less "everything possible, as soon as possible."

But with 3+4, you have the whole range of options available, and have to decide how to trade off the risk of the cancer progressing under active surveillance against the other long-term health risks from hormone therapy, surgery, and/or radiation. That uncertainty (there's no way to know you've made the "right" choice) must generate a lot of stress.