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He says most men will get that cancer anyways and hopefully he is old enough when he does get it because if he would do an exam earlier on in life, the negative side effects from the treatment will outweigh the knowledge of you having a cancer that most likely will not trouble you until you are already old.
Like a lot of things that is somewhat true but not at all applicable to everyone.
The biggest problem is that prostate procedures are about 80% of the business for urologists, and they mostly do radical prostatectomies (removal) which can easily have some of the side effects that your friend described. OTOH - there are other options: RF/microwave, cryo, brachytherapy seeds, external beam therapy (including gamma knife), and others.
If you have PIN that is highly likely to be metastatic, then you should take care of that --- without question. It can strike at a young age, and can easily be terminal spreading to bone. Yes, you don't die of prostate cancer but you can easily die if it spreads.