Trial of Prostate Cancer Patients Undergoing Active Surveillance With or Without MRI-Guided Management

Inclusion Criteria:

* Biopsy confirmed adenocarcinoma of the prostate.
* Biopsy must consist of at least 8 cores.
* Enrollment is =\< 1 year from diagnosis.
* One or two biopsy cores with less than 50% tumor present in each core and Gleason score =\< 6 (3+3).
* Candidate for multiparametric MRI.
* T1-T2a disease based on digital rectal exam.
* No concurrent, active malignancy, other than nonmetastatic skin cancer or early stage chronic lymphocytic leukemia (well-differentiated small cell lymphocytic lymphoma). If a prior malignancy is in remission for \>= 5 years then the patient is eligible.
* Ability to understand and willingness to sign a written informed consent document
* Zubrod performance status \< 2.
* Patients must agree to fill out the psychosocial questionnaires.
* Age \>= 35 and =\< 75 years

Exclusion Criteria:

* Not biopsy confirmed adenocarcinoma of the prostate.
* Biopsy consists of less than 8 cores.
* Three or more biopsy cores are positive.
* Gleason score \>= 3+4=7.
* A single core has \>= 50% involvement with Gleason score =6 (3+3) or less.
* DCE-MRI study before enrollment.
* Inability to undergo MRI exam.
* Greater than T2a disease based on digital rectal exam.
* Concurrent, active malignancy, other than nonmetastatic skin cancer or early stage chronic lymphocytic leukemia (well-differentiated small cell lymphocytic lymphoma). If a prior malignancy is in remission for \< 5 years then the patient is ineligible
* Inability to understand or unwilling to sign a written informed consent document.
* Zubrod performance status \>= 2.
* Patient unwilling to fill out the psychosocial questionnaires.
* Age \< 35 or \> 75.