@jneylon Urologists are surgeons so tend to recommend what they know; therefore, the comment about seeing a RO. With all disease on one side, he might be a good candidate for one of the focal ablation therapies (IRE/Nanoknife, HIFU/Tulsa Pro, Cyro (freezing), or Laser). These target the cancer vs. the entire prostate like surgery (removed) or radiation (fried). Tend to have higher recurrence rates but far lower side effects. Depending on specific location of lesions some of these will be better than others. Treatments covered by classic Medicare but may not be by commercial insurance or Advantage plans.
Several posts on this site about experiences especially with Tulsa Pro and Nanoknife.