A retrospective analysis found that active surveillance is increasingly becoming the top choice for veterans with favorable-risk prostate cancer in the US Department of Veterans Affairs system, with 93% selecting active surveillance in 2024 for low-risk disease. The data, led by UCSF and the San Francisco VA, reinforces a shift toward avoiding overtreatment where outcomes support watchful strategies. Separately, two analyses focused on focal therapy in prostate cancer highlighted a mismatch between where clinicians are using focal therapy and which risk groups guidelines support. Together, the findings set up a contrast: broad adoption of surveillance for low-risk disease, while focal therapy appears to be spreading into patient populations where evidence and guideline criteria may not fully align.