The data for focal isn’t mature enough. However for 70+ year old gents with 3+4 -4+3 I think it’s fine. Likewise, for the 50 year old with 3+4 that doesn’t want surgery, I’d rather go with AS. We need RCTs and long term follow up. The cash only practices that will focal anyone are wrong. However I’m surprised the at the vitriol from people at the even the pushing the science. Disclaimer, I don’t do any focal. Patients want this. They ask for it everyday. This shouldnt be about whether focal is going to replace RT or RARP, but rather who are the right patients in which focal provides adaquet oncologic benefit while decreasing side effect. No matter how good of a surgeon your are, or if you believe RT is without side effects, focal has less side effects. We need to investigate this option.