dmagic, I am not familiar with HIFU treatments.

I think you are doing the right thing getting a second opinion.

It is a personal thing to decide on what is best for you after getting opinions and research. A lot of research shows active monitoring of certain stages of prostrate cancer are appropriate especially when older. At 64 you are not that old. I am 76 and chose radiation treatments to cure the cancer and stop it from growing and possibly spreading.

Are you familiar with a test called Decipher? It is a genetic test on the already obtained biopsies that gives a more precise diagnosis of risk of the cancer. Low, intermediate, high. My original diagnosis form biopsies was intermediate. Decipher came back low risk. This changed my treatments from hormone and radiation to radiation only.

I would get second opinions. Asked your urologist about Decipher tests, PSMA, and bone scans. Have you seen an oncologist and or radiologist for consultations also. What I had was proton pencil beam radiation 30 rounds over 6 weeks. I did this after getting two opinions from different providers, doing all research I could, and having all the test I mentioned above done to give me as much information possible.