Hi @johalla, welcome to the Prostate Cancer group. Deciding on treatment is a cross-road all men face when dealing with prostate cancer. It is the subject of many discussions in this group. For that reason, I moved your question to this existing discussion called "How to choose treatment for prostate cancer?" started by @irishpat70.

You may also be interested in these related discussions:
- Prostate cancer: What treatments did you choose? Results? https://connect.mayoclinic.org/discussion/prostate-cancer-4/
- Anyone had the 5 treatment proton therapy for prostate cancer? https://connect.mayoclinic.org/discussion/anyone-had-the-5-treatment-proton-therapy-for-prostate-cancer/

I'm confident that members like @ken82 @assad4zamani @dandl48 @cmartin65 @waynen and others can share their radiation choices and experiences with you.

Johalla, what criteria are making you tend towards Low-dose-rate (LDR) brachytherapy?

I can't advise you on your question, since it wasn't my form of treatment. I had 20 doses of proton beam therapy. I didn't have any reaction to the therapy until after my 5th treatment when I had some pain during urination. I don't think one treatment would have an effect. What I don't understand is that you said a one time HDR. There's a fair amount of prep for the HDR, if they are talking about either Photon or Proton radiation. You have to know the size and location of the prostrate and be able to aim the radiation precisely at the target. Also, they take turns radiating one side and then the other. Not sure how they would ensure that the whole prostrate would be covered. The LDR and HDR are very different types of treatment. It seems like they would do one or the other. By the way, the proton beam therapy is painless and takes less then a minute for each treatment. The only issue may be some urination pain that can be treated. I think the latest photon treatment is similar.
You mentioned that hormone therapy is out of the question. My Gleason score for my worst cancerous cells was 4+4. Yours would be considered medium risk and mine is high risk. Since mine was high risk my doctor at Mayo prescribed 3 shots of Lupron with my radiation treatment. My survival chances increased by 20% with the Lupron. Although you can get by without it, I think the research says it also improves the survival rate for your situation. The hormone therapy does have some side effects but they do go away and at least in my case were tolerable.

Best of luck with your decision. Ask a lot of questions and go with what you feel most comfortable with.

I went through the same thing in 2014 as I did not like the optioned the urologist and oncologist gave me so I researched while researching about 3 months I did 12 hyperbaric treatments and about 48 high dose vitamin C via IV after this I decided on Focal Laser Ablation at the Sperling Prostate Clinic in Florida. You can talk with them and send them your medical info and will let you know if you are a good candidate. I am taking Lupron now and will be off it in one month and I maintain myself also by using marajuana oil (Phoenix tears) you can look up the protocol on the net search Rick Simpson Oil. I take it in the evening and sleep solid through the night with no wake ups. It’s up to you but worth I vestigating.

Tomorrow I will have the first of two HDR brachytherapy at the Rochester Mayo. I know some groups do not offer this as a mono therapy. I had the choice of two weeks of proton therapy or the HDR. I chose the HDR to reduce my travel and not having to stay in Rochester. The HDR for some feels more invasive but I feel like I am in good hands. The Prostate Cancer Research Institute has a good video on HDR Brachytherapy.