The lack of Level I evidence comparing various treatments for localized prostate cancer allows one to profess or proclaim a bias for almost any modality they choose. The lack of "good" evidence has confounded the issue by allowing those with favoritism toward any one modality with less robust data, such as proton beam therapy, stereo-tactic body radiation, or high intensity frequency ultrasound to have a voice in the chorus of identical outcomes. In the end, eitker side can state their case at a tumor board or with patients with impunity. The patient's confusion in selecting appropriate therapy is further complicated by the physician's bias that may be linked to ego or the pocketbook.
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