Walt,

I found myself in the same situation as you a few months out of treatment. My original tumor was fairly large 3cm X 1.8cm. Four months after treatment I did a PET that showed a pea sized remnant of cancer. They also saw some residual microscopic disease, which was like a sprinkling of cancer cells throughout the original tumor.

So this is different than a recurrence; this is a situation where the radiation treatment does not completely eradicate the cancer. In my case it was more troubling in that surgery was not an option. In your case it is still troubling because the radiation was not completely effective.

I got four opinions regarding my condition and I would recommend that you get as many opinions as you can before deciding on further treatment. I ended up choosing Cyberknife treatment which gives you higher concentrations of radiation over fewer treatments (50gy of radiation over 5 treatments for Cyberknife as opposed to 70gy of radiation over 33 treatments). My doctors felt this would get even the radiation resistant cells as they would be hit by a bigger blast each time. I did not get an opinion that included brachytherapy but I think they must be thinking along the same lines (radiation source close to the cells).

Either way I recommend you get as many opinions as you can before making a decision, keeping in mind that this is not a recurrence issue but a radiation resistance issue.

Best of luck,