Hi Bill,
Welcome to the site and sorry you find you're self here. I was diagnosed March(ish) 2024. Initially recommended surgery, then a second surgeon said HT/RT was the way to go. He could do the surgery, but it would be none nerve sparing and I'd most likely need salvage RT. The none nerve sparing really put me off, and why have a double wammy of side effects too!
I was due to have 20 sessions of EBRT + 24 months of HT. A few days before I was due to start I was called in and offered 15 sessions plus HDR Brachy, the HT was staying the same. I was warned ED and strictures were more likely, which develop over time especially with EBRT and Brachy combined. I went ahead as anything to reduce the chance of reoccurance. ED still bothered me but I thought I could handle it more if it progressed slowly (fingers crossed not at all!)
I've just finished HT and waiting for testosterone to return
The Brachy was very straightforward too, mine was done under general anesthetic. I walked into the hospital at 7am, and walked out again at 12:45 after proving I could wee ok. This is personal experience so I guess its not always so straight forward
I'm only a short way through the journey, but I'd still add HDR Brachy in, especially if it reduced the time on HT. I never had any hint of incontinence and the ED I'm experiencing is down to the HT from what I can tell. A pump and tadalafil from the NHS is helping mini me through the dark times.
Of all the treatments side effect I've found HT the worst, though hopefully these will wear off over the coming months. I'm on tamsulosin for a possible slight stricture (this is what I assume is the problem, I will query at my next telephone appointment if that's the case). It's only very mild and hasn't got any worse, I've tried stopping the tamsulosin, I was still able to pee but with reduced flow and it felt a bit uncomfortable.
All the best
John