@jcbagley
The information given to me by my R/Os at both Mayo and UFHPTI is that radiation will usually still get to and around colon as most R/Os will do margins. The Space/Oar is there to help move colon away from prostate radiation.

I was told the radiation will damage the very small blood vessels. After radiation will start healing by growing new blood vessels. They are very fragile though and things like constipation and straining can cause them to bleed. This is usually temporary as they grow stronger. Again, I am not a medical professional just passing on what was told to me by medical professionals. Some will have more problems and others none. I had minor bleeding that did go away.

You mentioned the high dose and low dose. According to my R/Os (two different medical institutions) both have almost identical success outcomes. What my Mayo PCP told me was that their research is showing now more side effects level of those getting the high dose limited number of treatments versus the low dose expanded number of treatments. I had 30 rounds of proton radiation.

It has to be a persona decision. And that includes your mental outlook. Some want to get the treatments over and getting them causes stress and anxiety, so they want to get a high dose and get over it. Some like me got low dose and 30-40 treatments preferring less chance of side effects if possible.

If I had a chance to do it over, I think I might have selected the high dose limited number of treatments. Why, not because I had any significant problems at all. It was simply hard driving 5 days a week to UFHPTI (45-minute drive) for 30 rounds. It took from May to July to finish because of the holidays.

Mayo Jacksonville did not offer proton radiation, just photons. I chose to have the proton again after research and consultations with 2 different medical facilities and then finally with my Mayo PCP where we decided as a team that proton low dose and thus the high number of treatments was the best for me at time.

I hope that helped. I did not have hormone treatments so cannot comment on that. I would solicit feedback from those who did get it to provide you others feedback on that.