You can request they put in a hydrogel spacer to protect your rectum. They put it in with a needle and it evaporates into your body and comes out in your urine as it deteriorates. Also called SpaceOAR. Some radiation oncologist, swear by it others don’t want to use it. You need to ask your radiation oncologist.

Frequently it is put in by the urologist but some radiation oncologist want to do it because they feel they have a better feel for it.

Brachytherapy is a pretty common procedure and is successful for many. With a Gleason 9 recurrence is common, after a few years, get regular PSA tests. There are many more treatments in the future, if you need them, that will keep you living for a long time.