I was also thinking about HDR Brachytherapy with Dr. Chang at UCLA, he has done over 1500 procedures and was recommended by the Prostate Cancer Research Institute when I reached out to them. I also have localized PCa as per my PSMA PET scan, only 2% of my 50.4CC prostate, I have Gleason 4+3=7 and I'm 70 years old. There just does not seem to be very many radiation oncologists that mention or recommend Brachytherapy and Mayo Phoenix does not do the procedure once they got their Proton machine. I have been researching BT and there are also side effects just like regular radiation, but I would think they are less as it's more targeted. The procedure des not reimburse as well as other RT procedures. I am just disappointed that in the year 2024 there is not a procedure for localized small volume PCa with little to no side effects. I may just do Active Surveillance for a few years and enjoy my early 70's as much as possible. My Decipher score was only 0.38 so low risk of metastasis 3.4% 10 years and 3.4% of risk of death in 15 years from PCa ( with standard of care treatment) but even with no treatment even if it doubles, that's still only 6.8%