50 and Full of Life. Need advice. TULSA or HIFU or what?

We're all here for the same reason, so I'll try to keep my introduction short.

I'm 50, still very young (IMO), full of energy, extremely active, healthy, and have a satisfying and active sex life with my wife. I began chasing increasing pelvic and low back pain in mid-late 2025 that I attributed to bicycle riding and racing. PSA scores of 6.2 and 6.6, followed by CT, MRI and biopsy confirmed Gleason 3+4 cancer, (Favorable Intermediate). Local urologist is a surgeon and recommends surgery / removal. Local oncologist is a radiologist, refers to it as Unfavorable Intermediate, and recommends EBRT and ADT (hormone therapy).

I'm an analyst by trade and don't like either of these options, due to their side effects directly impacting my quality of life, which I hope to be as long as possible.

I'm working with my local urologist and insurance company (BCBS) to provide me with an approved out-of-network referral to Mayo (Rochester), and in the meantime have a Mayo consult scheduled for Jan 15th. I have no idea what treatment options will be recommended, but I pray to God they're better than the two antiquated ones that have been recommended locally.

TULSA looks extremely promising to me, as well as HIFU, and I believe I am a qualified candidate for both.

Are there specific questions you all suggest I ask in my consult? Any other treatment options I should ask about specifically? Do you need me to provide additional specific info about my cancer in order to provide quality feedback?

Thanks in advance, and I've already gleaned a ton of info from reading may of the discussions here.