Upon initial "diagnosis" I was very attracted to the ablation strategies as opposed to surgery. However, the research urologist whom I consulted about a clinical trial ruled me out due to that same gleason score--4+3, meaning that in this site you had more grade 4 than grade 3 cells in at least one of your biopsies. Based on what I've read, I would also be further concerned by your low PSA. The reason is because I understand that low PSA for a given grade of cancer might be associated with more aggressive cancer. So I ended up going with surgery, and even then the post-surgical biopsy found positive margins, meaning that the cancer extended to the edge of what was removed intact (in one small area.)
MRI/ultrasound-guided ablation is more targeted and therefore has less side effects, but the researcher (who did not do my surgery) noted that he had seen more long term complications from radiation than from surgery. Of course, things are always changing, but I considered this my best advice and reluctantly proceeded directly to surgery.
One other thing that I found interesting is that these radiation setups are hugely expensive, and so, while the outcomes are not (or not yet?) better for many patients, those who have invested in these setups have a compelling interest in seeing them widely used. The same thing happened with open vs robotic surgery--no better outcomes for robotic, at significantly higher cost, but once a new generation of surgeons trained on the robots [RALP, ] they have become increasingly prevalent. And yes, that's what I had. Thank you, medicare.
Of course, at some point I may need radiation as well, and once the prostate is gone apparently it's a lot harder to target!