Hi Husker,

Three years ago I was diagnosed with prostrate cancer with a GL of 4+4. I chose Proton beam therapy at Mayo. They inserted the carbon markers but not the SPACEOAR. They inserted into the rectum a balloon filled with liquid before each treatment. It does the same thing as SPACEOAR. The insertion of the carbon markers had some slight pain, but nothing to worry about. If your doctor says this won't hurt, ask him if they've ever had it done to them.
I chose Proton beam therapy because I felt it caused the least amount of damage to surrounding tissue, which was the case. The only issue that you can't avoid is damage of the urethra because it runs through the prostrate. I had 20 doses of radiation and after the 5th I had pain with urination, which is common. They prescribed Flomax, which I still take. I didn't have pain after taking Flomax, but the walls of the urethra have hardened so I will continue taking it to help with urination. I believe the most recent forms of photon radiation is able to reduce tissue damage by bypassing any organs.

Don't know if you will also be taking Antigen Deprivation Therapy as well. I had 18 months of Lupron, which is standard for higher risk cancer. Yours is moderate and it's more optional, but the side effects of ADT do go away with time. Given the benefits, it's worth it

Best of luck to you. Been there. Keep a good attitude.