How do you counsel/advise patients when asked to compare ultrahypofractionated radiotherapy with the TULSA procedure?

I start by noting that the three NCCN-guideline recommended management plans for favorable-risk prostate cancer are radiotherapy (including SBRT), surgery, and active surveillance, and the latter two often require additional local therapy to render a patient cured within the next 5-10 years. In general, these options are considered equivalent on the endpoint of survival based on ProtecT, although they have different side effect profiles.

We next discuss that TULSA is not on this list. The reason being that we do not have high-quality, mature, clinical trial data to compare TULSA to the above options. This does not mean there are no data, however, but it is helpful to state this to define the uncertainty in our discussion. Further, I discuss...