I wanted to add that this was perhaps the hardest decision I've ever had to make, and took several months to sort it out and get educated about PC. There are great hospitals here on the east coast like John Hopkins, Sloane Kettering, MD Anderson Camden NJ, to name a few who I could of treated with. The two COE's I consulted with near my home were Univ of Penn & Fox Chase, both great cancer centers. Penn offered me a trial of HDR Brachy, 5 sessions of proton & short course of ADT. Fox was same triple therapy but 23 sessions of IMRT first then the HDR brachy after with short course of ADT. I decided on Dr Chang because of his experience with Brachy plus his procedure doesn't require heavy general anesthesia with being intubated & on ventilator for 4 hours like Penn & Fox. Dr Chang does brachy procedure and rectal spacer in under an hour using Propranolol anesthesia. Plus he was highly recommend by Dr Scholz and all the positive things I've read from others who had treatment with him at UCLA. One problem I'm running into because I can't stay out in CA for 3+ weeks and have SBRT done there is finding an RO back at home to do the 5 SBRT sessions and take over my care. Penn will only do 25 proton sessions not the 5 SBRT if I have Chang do procedure. Penn said they only do the 5 SBRT as mono treatment unless you are in the trial. Asked Fox and waiting for a response but they will probably say no as well because these doctors ego's get in the way, thinking why don't I trust them to do the Brachy procedure. I told both RO's from Penn & Fox who have done many Brachy procedures that I trust their expertise to do the Brachy but it was the long anesthesia I didn't want. Hopefully Dr Chang can call an RO here on east coast on my behalf and setup the SBRT. It's different when a doctor asks another doctor. Plus most doctors know of Dr Chang. My family & friends think I'm crazy to go all the way out to CA when we have these great COE's close to home but this is what I feel comfortable with. Sorry for this long post.