If the alpha/beta ratio for prostate cancer is lower than the surrounding normal tissues (Brenner et al. have estimated the alpha/beta for the rectum to be over 5.0), doses greater than 2 Gy (hypofractionation) will afford an advantage as there will be a greater sensitivity of prostate cancer to radiation, as compared to the bladder or rectum. This benefit has been exploited for many years with High Dose Rate (HDR) brachytherapy using Iridium -192. Typical doses for HDR are 19Gy in two fractions in addition to 46Gy in 23 fractions of EBRT (4). With reference to our own institutional data from HDR brachytherapy we calculated the dose distribution in recently treated patients. Due to the nature of the iridium dose distribution, there are considerable areas of much higher dose delivered; 200% of the dose (38Gy) to 12.7% of the target volume, 150% (13.75Gy) to 32.6% of the target volume and 125% (11.9Gy) to 60.1% of the target. Despite the high doses to the periphery of the prostate it is possible to limit the dose to the rectum and bladder to 1cc < 75% (14.25Gy) and the 1cc urethra to <125% (23.75Gy) (4). HDR brachytherapy series have reported durable long term Biochemical Failure Free Survival (BFFS), which are as good or better than comparable external beam or surgical series(5). However despite the low toxicity and excellent biochemical outcomes, HDR brachytherapy utilization in Australia is low, with under 300 cases in total per year. This is due to the logistical difficulty of HDR brachytherapy, anaesthetic requirements, nursing care and patient discomfort.