Oldv8, if you're confirmed as G6, then the possibly least invasive treatment would be LDBT (low density brachytherapy)-- they implant radioactive seeds inside the prostate, and it cooks it from the inside out. The seeds are permanent--so it's pretty much once and done.
I had surgery, and I hit trifecta within 3 months (non-detectable PSA, fully continent, no ED issues). I'll also say that I seem to be fairly rare in here. I'll add my caveats: "continent" means that I'm as continent now as I was before surgery. I had some moderate BPH going on then, and I dripped a little from time to time. Not really different now. No ED means that I am on 2.5 mg of cialis daily. It also helps with the overall blood flow, which is important immediately after surgery.
There is one regular in here who is in your area--he bills himself as "Cyclone"--which tells you where he is in Iowa. There are others from that neck of the woods as well.
You commented about
"missing the mark" with radiation--which is much less an issue today with some of the newer methods. SBRT, for example, implants marker seeds (gold?) in the prostate, and the radiation machine uses them to focus on, so hitting the spot is pretty much guaranteed.
Keep doing your research, and I'll note that most guys "know" when they meet "their team". It hits you in the gut, and you relax. Really. After that, you know you did all the legwork, and you'll know you're making the right decision..for you.
Age at Diagnosis: 56
RALP on 2/17/15, BJC St. Louis, Dr. Figenshau
58.5g, G3+4, 20%, 4 quadrants involved
PSA Non-Detect since April, 2015
My Story: www.healingwell.com/community/default.aspx?f=35&m=3300024