 - Arm I active monitoring: Patients undergo active monitoring of their disease. Patients are seen by the research nurse 3 months after randomization to fine disease management plan. As part of this process, patients, together with the urologist or research nurse, develop a management plan that includes repeat PSA testing every 3 months in the first year and then every 6 months thereafter to detect biochemical progression. Patients also undergo an annual review appointment with an opportunity for digital rectal examination, if indicated e.g., rise in PSA or new symptoms. PSA levels are monitored and tests repeated as needed. Additional review appointment is arranged with the study urologist for confirmed rising PSA level, apparent symptoms of spreading disease, or concern about the PSA levels. At the review appointment, the study urologist discusses issues raised and current options, including remaining on active monitoring, undergoing re-staging of the cancer, or receiving other treatments, as appropriate. 