I met with the oncology team and they discussed my situation thoroughly. I did a ton of research on my own, everybody’s different but for me brachytherapy was the best option. HDR brachytherapy offers a quicker recovery and a generally better long-term quality of life due to fewer severe side effects. Radical prostatectomy involves a longer recovery period and may have more significant impacts on quality of life, particularly concerning urinary and sexual health. Time will tell, I went through my first treatment yesterday. Feeling surprisingly well this morning.

Let me step in and explain why I considered HDR Brachytherapy as an alternative to surgery.

When I was diagnosed at Moffitt Cancer Center in Tampa, Florida with low risk Decipher, intermediate Gleason 7 cancer confined to the prostate, I was offered surgery, various photon therapies and HDR Brachytherapy. Moffitt's Proton therapy won't be available until 2026, so they never discussed it. If I had stuck with Moffitt, I would have chosen HDR Brachytherapy, trusting in their ability to deliver it accurately. The way I understood it, they would sew a temporary plate to my perineum with guide holes for the many delivery tubes that would be inserted into my prostate at predetermined locations. This would be done under a spinal block of some sort. Once tube placements were confirmed by imaging I would be taken to a treatment delivery room where a computerized machine would insert, retract, and repeat the process for all inserted tubes. The radiation seed would be precisely exposed for a predetermined time at the end of each tube and then retracted to be inserted into the next tube, etc. When finished, the plate and tubes would be removed and the whole process repeated one more time a couple weeks later. So with this therapy, you expose nothing outside the prostate to radiation, as you would with both photon therapy and to a lesser extent, proton therapy. If accurate (and you have to trust the science here), this treatment should leave you with fewer side effects than surgery, where you risk the dangers of anesthesia and surgery, snipping out the prostate and other tissues, including a section of your urethra that must then be stretched and reattached to the bladder neck, etc. So it only takes two days of treatment with HDR Brachy, two weeks apart. But I did some further research and went with proton therapy in Jacksonville, FL at UFHPTI instead. So far, so good.