I am a firm advocate of mms, but I want to tell you there are other options other than surgery, as my husband had prostate cancer 8 years ago, we hadn't heard about mms, but we had a few friends who had surgery and were left with miserable outcomes.
First, a PSA of 5. is really low, your cancer is smaller than the tip of a pen. You must have a gleason of 6, please read this article from the Oncology Journal, here is the first and last paragraph:
www.cancernetwork.com/oncology-journal/gleason-6-prostate-cancer-serious-malignancy-or-toothless-lion
Autopsy studies of men without known prostate cancer suggest that a substantial reservoir of prostate cancer that does not cause symptoms or death exists within the population. The majority of these cancers are Gleason 6 tumors and are frequently detected by prostate-specific antigen–based prostate cancer screening. There is strong evidence from longitudinal cohort studies of men with both treated and untreated Gleason 6 prostate cancer to suggest that Gleason 6 disease, when not associated with higher-grade cancer, virtually never demonstrates the ability to metastasize and thus represents an indolent entity that does not require treatment. Whether Gleason 6 has a propensity to progress to higher-grade cancer is still under investigation. Because the term “cancer” has historically been used to represent a disease state that leads to progressive illness that is uniformly fatal without treatment, we believe Gleason 6 disease should not be labeled with this term. Our challenge now is to develop the technology to differentiate true Gleason 6 disease from the higher grades of dysplasia with which it can be associated.
and the article ends saying:
With reported median follow-up ranging from 22 to 82 months, current active surveillance cohorts remain immature at this time, and longer follow-up will be necessary to draw definitive conclusions. Thus far, cancer-specific survival among these cohorts has been > 97%, and there are no data to suggest inferior outcomes after delayed radical therapy, as compared with immediate therapy.
My husband had a lowish PSA as well, 7.60, his doctor told us that he had 30 days to decide, radiation or surgery. Later I would find out he had 20 years to decide, as prostate cancer grows slower than anything. Thankfully we found HIFU (High Intensity Focused Ultrasound), it had been invented in 1941 in Indianapolis, Indiana by a doctor who had surgery for prostate cancer and said "no man should suffer this outcome". The medical industry saw the ramifications of such a cancer machine, and they were right, it is being used to cure cancer all over the globe, except in the USA. However, there are clinical trials right now in Virginia for breast cancer.
It was a two hour procedure, where he was put to sleep using a spinal - which is to keep him from moving. After the anthesia wore off we went out to lunch and to the beach. He had no side effects ever, didn't need any drugs, no pain, no cutting, it was just a high ultrasound. We have some 10 friends who have also gone for HIFU, you can get it in the Bahamas, Mexico, Burmuda, Canada (Cleveland Clinic in Canada does it), there are many American doctors who travel to off shore to treat men, we used Dr. Stephen Scionti, the most experienced HIFU expert, he is also a cryosurgeon, which is the same technique. He will talk on the phone if you call him forever, making sure you understand every detail of your cancer, and he will also tell you that you do not need any treatment if tht's the case, he needs you to fax him your biopsy results. google him + HIFU
There is another way to combat your PSA score, and that is the hair loss drug, Finasteride. I only recommend this if you are over 60, because it messes with your hormones. It blocks one of the male testosterones, thus stopping the growth of the cancer. Orignially doctors thought it caused a more aggressive cancer later, but that has been proven totally false. I know a guy who takes 5mg finasteride for his PSA, it lowered it more than 50% right away. I guess he needs to take it forever, but he doesn't think so, as he quit after two years and his PSA has remained at the low. He said he did have a side effect, his ability to get an erection was the same, however it took longer to climax.
My best wishes to you