Mayo Radiation Oncologist Advice -- Sorry again

@benzo
Do not feel you are alone in your feelings. I think all of us had same feelings of am I doing the right thing. The key is "doing the right thing" for me.

That is the key to deciding with your medical professionals of what is best for you both physically and mentally. What others did or are doing is specific for them and their experience my help you but with caveat you may not have same outcome or side affects as we are all different.

If you are going to Mayo you are going to a medical institutions who's motto is "Patient First" and is all you can asked for. Of course when you go to a radiologist/oncologist you will have some who have more experience with one type of cancer.

What is your urologist saying? I am sure you saw them to get your biopsies. Is she/him at Mayo also. Express your concerns with him/her. Just remember this is your body and what is best for you is up to you and your medical providers.

And also consider a second opinion before you decide. I did this to help ensure making right decision and so have many of those on MCC.

I just had cryoablation @ MayoMN several years after Tulsa Pro (Scionti in FL). But locally to me in western NY, before my cryo treatment I went all the way to nearly getting HDR but was eliminated due to pubic arch interference. What I learned at that time was doctors who are not true craftspeople turn it into HDR + EBRT to cover things up due to not doing the HDR well. Basically a true craftsperson (an experienced doctor) can get it all with HDR and not need beams. I am sure you will hear the opposite but that is what I learned, you find the best doctors they don't add external beams of any kind, provided you qualify based on sizes and no interferences involved. Many doctors treat brachy poorly because they don't like the craftsperson part, you want a pro if you want that route.

Agree about having an experienced doctor do the HDR brachy. Most cancer centers of excellence use the HDR brachy as a boost and also include some type of radiation along with it, even if a short duration like 5 sessions of SBRT. Some patients are candidates for HDR Brachy "mono" therapy, no radiation or ADT. One of the best doctors doing HDR Brachy procedures is Dr Chang at UCLA. He has done thousands of them.

@jc76 I did not ask my urologist before I came back, and he asked some one set up earliest appointment for me. I will send an message to his office now.

The appointment slots go very fast, actually, there is no time to think, just pick one. Just in 2 days, all times within month gone. I just keep the sept 10th appointment. Add this comment that others new comers will not get prepared, not like me.

Dr. Ryan Philips is very knowledgeable and helpful. Talks at my level, easy to understand. Although metastasis foci keep coming back on my PSMA Scans, I'd say he's pretty good with the laser. I guess coming back is not correct - still spreading.

Your case is your case. Everyone else's is different.
From my experience at Mayo, AZ.... if you don't know whether to chose Dr. A or Dr. B, ask Dr. A and Dr. B. Be proactive: "I've read about such and such care, what are your thoughts?"
I have done that repeatedly, and every time my concerns were respected and fully addressed.