first post following diagnosis.

One thing that will influence your decision will be the % of each core affected, and whether the cancer cells are towards the centre or towards the edge of the gland. Some oncos would say that G7 (3+4) is not suitable for brachy but it might be that the element of 4 is very, very small. Other oncos will use brachy in conjunction with external RT in high risks cases.

There are two types of brachy, used for two very different diagnosis.

LDR, or seed, or permanent brachytherapy tends to be used on T2 low risk diagnosis.
You didn't give enough details of your diagnosis, but you might be T2 low risk.

HDR, or temporary brachytherapy is currently popular with External Beam Radiotherapy for high risk cases,
Gleason 8 or above, or T3, or PSA >= 20.

For ED, you need to know if you are eligible for nerve sparing with a prostatectomy. It's a risk with just about every treatment, but the risk varies. With prostatectomy, you will lose erections afterwards, but if you have nerve sparing, around 3 in 5 people get it back between 6 months and 2 years later. For Radiotherapy, it rarely has any instant impact, but around perhaps 2 in 5 cases, erections are lost slowly between 2 and 7 years later.

One other thing I would warn you about. When diagnosed on the NHS, you come under a multi-disciplinary team (MDT) consisting of urologists, oncologists, radiologists, etc (there were 30 clinicians in my MDT). They reach an agreement on what treatment is (or treatment choices are) best for you, and this stops one consultant just pushing their on procedure. When diagnosed privately, many people only ever see one consultant, and get pushed into doing what their particular procedure is. Do make sure you are getting good advice about a range of treatments.

Edited by member 17 Sep 2019 at 15:25  | Reason: Not specified

Thanks so much for the replies, it's very useful information. Just to give you a little more context to my position I am just about to leave my current job where the private medical cover has come from (it stays in place until 31st october) so i will be back in the hands of the NHS from that point, which from what i have read seem to be very capable in this field.

I didnt mention the fact I was classified as Stage T1C

Thanks again

Kev

Keep in mind though that this is one person's experience and yours may be quite different; for example, not all hospitals require the patient to self-inject afterwards, not all patients will have a named nurse (or may have one but will never meet, speak or get a call back from them) and not everyone gets district nursing support afterwards. 

Further update following a visit to  A Reading based  oncologist today.

It seems that I am a very good candidate for the Brachytherapy seed option, which I am so pleased about. We did discuss options should I get a reoccurrence and he said that he only had 1 patient who needed a total prostrate removal following Brachytherapy and this could be done in London. So that was another worry of the list . So given my age, diagnosis, the significantly lesser side effects I am going ahead in October with the Brachytherapy.

Thanks again for the comments you have given 

Kev

Edited by member 24 Sep 2019 at 21:58  | Reason: Not specified