@jeffmarc I re-watched the video. Dr. Weidhaas says:

"...but low-dose Brachytherapy is really not like anything we've talked about. It's such a low delivery, slow, slow delivery of radiation. Weer actually doing a study right now to see if our Prostox Standard predicts that or if it's a signature on its own."

So, no, she did not recommend low-dose Brachytherapy.

And in our Prostox report, there's no mention of any alternative treatment. Here's all we got:

"INTERPRETATION
Based on the genetic biomarkers assayed, the patient falls in the categories of:

• HIGH RISK for SBRT
• HIGH RISK for CFRT

For Developing Grade ≥ 2 late genitourinary TOXICITY after prostate directed treatment.

NOTES

For PROSTOX ultra: DNA was isolated from the swab specimen submitted and amplified using quantitative real-time polymerase chain reaction (RT-PCR) to genotype 32 microRNA-related germline variants. Based on the results of the analysis a proprietary algorithm was used to calculate the risk of significant (grade ≥ 2) late genitourinary toxicity following stereotactic body radiosurgery (SBRT).

The PROSTOX ultra signature has a negative predictive value (NPV) of 96%, a positive predictive value (PPV) of 89%, specificity of 95% and sensitivity of 79%. A high-risk result predicts a patient toxicity risk of ~65-80%, and a low-risk result predicts a patient toxicity risk of ~4-7%. A patient with a high-risk result is ~8-10 times more likely to experience toxicity following SBRT than a patient with a low-risk result.

For PROSTOX CFRT: DNA was isolated from the swab specimen submitted and amplified using an Agena MassARRAY to analyze 21 microRNA-related germline variants. Based on the results of the analysis a proprietary algorithm was used to calculate the risk of significant (grade ≥ 2) late genitourinary toxicity following conventionally fractionated radiation therapy (CFRT).

The PROSTOX CFRT signature has a negative predictive value (NPV) of 95%, a positive predictive value (PPV) of 72%, specificity of 94% and sensitivity of 76%. A high-risk result predicts a patient toxicity risk of ~60%, and a low-risk result predicts a patient toxicity risk of ~4.6%. A patient with a high-risk result is ~12 times more likely to experience toxicity following CFRT than a patient with a low-risk result. Comparatively, receiving a high risk result here means someone is about 4 times as likely to experience toxicity than the general public without a genetic test.

These tests have not been approved by the United States Food and Drug Administration and should not be used as the sole indicator of risk in determining treatment.

Limitations: Results do not predict a patient’s likelihood of clinical response, short-term side effects, or non-urinary side effects from SBRT or CFRT. A low-risk result does not rule out any possibility that the patient will experience toxicity, and a high-risk result does not guarantee that the patient will develop toxicity. Results should only be used as part of the
consideration of treatment choice."

That's it. Imagine how we felt when both our urologist and radiation oncologist talked about "cured" and then you see "• HIGH RISK for SBRT • HIGH RISK for CFRT" on your computer screen.

Cheers.