I'm 71, Gleason 9, Stage 2; PSMA PET Scan shows no metastasis and no spread, just one big tumor (~1.5cm) in the right side of my enlarged prostate (~65cc). I'm reasonably fit & healthy.

After much research and several consultations, I decided on HDR Brachytherapy with Dr. Chang at UCLA, followed by 5 treatments of SBRT.

Because my PC is high-risk, I'm glad Dr. Chang treated my whole prostate plus local lymph nodes.

I finished these radiation treatments just recently (end of March 2024).

Side effects so far?
1. I started Flomax (Tamsulosin) just prior to treatment... no issue with urine flow, but there is increased frequency & urgency. And I needn't have worried about the urethral catheter: It was inserted while under anesthesia, and easily removed a few hours later before I was discharged.
2. For me, bowel movements are also more frequent & urgent, which I believe is a result of the rectal spacer (SpaceOar), which apparently causes smaller-diameter lower-volume poop. At my 1-week follow-up, Dr. Chang said pooping should improve as SpaceOar slowly dissolves over the coming months. I regularly use a stool softener anyway, so I increased my dose to prevent any hard poop & constipation. And I follow a high-fiber diet with lots of leafy greens. But strangely, after HDR Brachytherapy, only a bland low-fiber diet is recommended, soon progressing to your regular diet as tolerated.
3. I wake at least 3-4 times a night to pee or poop -- only somewhat worse than my pre-treatment routine.
4. Flomax lowers my blood pressure... light-headedness, especially if I stand up too quickly.

Of course, my treatment plan includes ADT; I started Orgovyx 6 weeks before HDR Brachytherapy, with typical side effects (hot flashes, fatigue, loss of libido). And the resulting low testosterone can cause a loss of muscle mass. So I continue my regular brisk walking daily (2-3 miles) and workout with free weights. Some days, initial fatigue makes it difficult to start, but once I get going my exercise habits kick in. (OCD can be a good thing.)

That's about it for now. Of course it's stressful -- and sometimes very unpleasant -- but it's all been tolerable.

Best wishes.