@bob1955
Someone just asked me about this and I pulled up something. Someone said about VMAT previously.

Someone wrote this in a previous message unfortunately I didn’t capture the actual message. Maybe the writer will recognize it.

I was 3+4 with a high Decipher score. Underwent 39 sessions of VMAT with the TrueBeam after having fiducials and SpaceOAR inserted. That was 2 years ago and I am now in remission. I had a single day a few months ago with some blood accompanying a bowel movement, but nothing since. No other side effects (I had ED before the treatment and still have it, though treatments suggested here have helped greatly with that).

On the other hand, I have a friend who was also treated using a TrueBeam linac at a different location. He had fewer sessions and did not have the SpaceOAR. He has suffered greatly from radiation proctitis and has undergone numerous procedures to stop his rectal bleeding.
If you choose the TrueBeam option, I would strongly encourage you to have a spacer implanted. Good luck.