Hello, At this stage prostatectomy is not necessary. I ve gone through your history and I am of the opinion that you seem to have a low risk (low Gleason score: Non-aggressive) type of prostate cancer which appears to be without symptoms. Since, you have any symptoms, active surveillance (regular follow-up blood tests, rectal exams and possibly biopsies) may be considered to monitor progression of your cancer. If tests show your cancer is progressing, you may opt for a prostate cancer treatment such as surgery or radiation. However, active surveillance carries a risk that the cancer may grow and spread between checkups, making the cancer less likely to be cured. I therefore suggest radiotherapy (external beam or brachytherapy) with hormone therapy (Leuprolide or Goserline with Flutamide) as a treatment at this stage. Side effects of radiation therapy can include painful, frequent or urgent urination, as well as rectal symptoms such as loose stools or pain when passing stools. Side effects of hormone therapy may include erectile dysfunction, hot flashes, loss of bone mass, reduced sex drive and weight gain. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mohammed Taher Ali