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.