Thanks for the quick reply. Regarding the placement of the carbon markers, I had read that they would be gold markers not carbon. Isn't carbon toxic to the body? At least with gold ones they're worth about $2,000 per oz and could help to pay for a lot of Depends !! In the case of Brachytherapy "small, completely dissolvable radioactive beads (coated in Titanium) are implanted around the entire prostate area. This therapy targets the affected area more specifically than IMRT and other external radiation therapies, resulting in a shorter treatment time and, often, fewer side effects. Within one to four weeks, depending on what type of seed we use, treatment is done,” Dr. Runz said. “There is no need for the seeds to be removed.” I had a transperineal biopsy performed using "micro ultrasound" which is the latest thing and much better images than standard ultrasound. It was actually able to find a third lesion as opposed to only two detected by the MRI. The one Gleason 7 tissue sample was sent out for a Decipher test which I highly recommend your friend request which Medicare will pay for. It examines the DNA of his cancer cells and makes a risk assessment as to whether he is at Low Risk, Interm Risk or High Risk. Mine was Low Risk at 0.37 where they said I was a good candidate for Active Surveillance(AS) or local radiation. Since my dad died of PC I don't want to end up like him. Regarding AS make sure your friend reads the report on the NBC TV website. Use the following search phrase "Study finds prostate cancer treatment can wait for most men." This long term study (started in 1999) was released March 11, 2023 and involved 1,600 U.K. men. It concluded that there was no difference in PC death at 15 years between the 3 groups. Survival for all three groups was 97%. regardless of treatment approach. These findings do not apply to men with high-risk or more advanced disease who need urgent treatment. If I and your friend choose AS, it may be possible in just a few years to benefit from the new field of "radiopharmaceuticals." This will be a game changer. Use the following search phrase "Cambridge biotech raises $90 million for drug that uses radioactive atoms to fight prostate cancer." My plan is to get a second oncologist's opinion and then decide what to do, either AS or 5 Proton Beam treatments using the CyberKnife robotic arm approach. One website said that 5 Proton Beam treatments using a higher dose of radiation was found to result in much lower cases of PC recurrence as compared to 20 to 30 low doses over 6 to 8 weeks. Thanks for your info since I learned a few more things. What are your thoughts? Tell your friend to read about the experience @bjroc has had regarding using AS dated May 15, 2023. This is exactly what I fear, things just start to go South without warning. As my first oncologist said to me "Radiation is the price you pay for insurance."