chaimkugel: I had similar numbers to you. I looked at Proton, MRIdian narrow margin machine and removal. I went to 5 radiation oncologists, including Weill Cornell/NY Presbyterian, Miami Cancer Institute and Moffit cancer center. I decided on the Mridian using 2mm margins, real time mapping and adjustments, if needed, and 5 fractional treatments. Finished last February. I also had the spacer, Spaceoar, though BioProtect is supposedly more effective now, to add space between my rectum and the prostate and minimize exposure. Like you, QOL was important. The Mirage study compared normal 3-5 mm margins to the Mridian. If I had a biological re-occurrence, I would make the same decision again. I also had the Decipher test from my biopsy material which DOES get used by doctors to evaluate treatment.

I understood the risks and tradeoffs between the different types of photon machines, types of Proton machines, ablation (hot and cold) and removal. The Mayo clinic web site is obviously really helpful. It was also helpful to speak to patients on the phone. Some cancer centers have volunteer patients and some do not. Private message me and I will be happy to speak with you about my experiences and decision process.