Good Morning Bill,
Sorry for the delay in posting an answer. I sent a reply out on Tuesday, however I just noticed it's not posted, so I'll try again.
I've just completed the IMRT phase of treatment at Samaritan Hospital in Troy NY. I would have liked to complete my therapy in Tulsa, however it was not practical for me to be away from my home and business for a five-week period. CTCA worked with my local Cancer center and provided the parameters for the IMRT.
My numbers were the same as yours with the exception that my gland was 23 grams. The tumor itself was located in the apex of the gland, which meant that it might not be effectively treated by conventional Brachytherapy - permanent seeding. This was an opinion offered by Dana Farber in Boston. All of the information I have indicates you are a great candidate for HDR, however don't stop asking questions. A close friend of mind offers the advice that "all decisions become easy if you ask enough questions". That advice served me well during my quest for info about treatments.
I never considered surgery as a good option. I didn't care for the long recovery period, the risks from major invasive surgery, and the high rates of probability for serious side effects.
I feel that the high success rate for normal Brachy will be improved by HDR. The application of the radiation is far more precise and done at a higher, more effective rate. I was also influenced by the follow-up therapy through the use of IMRT. This of course is also offered during normal Brachy. It is also used after some surgery cases when there is a need to "clean up" the area if it is found that the cancer has not remained encapsulated. All things considered, I feel that HDR offered me the best chance for total healing.
Following HDR there was some discomfort around the area where the catheters were inserted. During the procedure there was absolutely no discomfort. I opted for the spinal for pain control. For five days following the procedure there was some rather intense pain at the start of urination. There is a little discomfort, even today, however I'm told that it will gradually fade away. In my case I think it's aggravated by the amount of coffee I continue to enjoy.
I have not had any rectal problems stemming from either IMRT or HDR. My sexual appetites and abilities remain at pretreatment levels although I've been cautioned that they could diminish over the next eighteen months. The IMRT treatments are given in total comfort as long as you’re not too modest.
Those are the high points of my adventure in dealing with this disease. I encourage you not to be rushed into making decisions, even by family and friends. This is probably the most personal decision you'll ever make. And you will make the one that's right for you. Having the right attitude makes a tremendous difference. Diet, exercise, and supplements play a huge role in your wellness. I think that's the one outstanding thing CTCA offers you. They look at you as a person and treat you as such. You're not just a number with a certain disease. I like the total approach. Take a hard look at their naturopathic, nutrition, and physical therapy programs. Total support for the total person can only add to your confidence.
I made a conscious choice to have a good attitude about the fact I have cancer. I also was determined to surround myself with a supportive team. You cannot ask for better team members than the people at the CTCA.
Good luck on your trip to Zion. If you're staying over, ask to be put up at the Villa. It's not the Hilton, however the lady that runs the place is an inspiration.
Call or write if you have more questions that I may be able to help answer.
Best regards
Larry