I have Gleason 3+4. Still evaluating but settling in on MRI radiation therapy. As they radiate, they can see how the tumor is affected by the treatment in real time. They also see where the healthy tissue is so mapping and protecting healthy tissue looks like it may be more accurate. If your prostate naturally moves, the machine turns off. No fiducial markers are necessary.

jb2buckwater, I chose proton beam therapy at UFPTI. Mayo Jacksonville only offered photon. Even though Mayo Jacksonville has had excellent results with the photon I wanted to do everything possible to reduce the damages affects of radiation as I could.

I came to conclusion with my primary care doctor concurring if doing proton would help reduce radiation damage that is the path I was going to choose. Both proton and photon have the same cure rates. The main difference is that proton releases very little radiation going in and NONE coming out past prostrate.

Photon cannot do this and passes through body, prostrate and out the other side of body.

You will read a lot of pros and cons of doing both. But you are the boss of your treatments and if you do research, get a couple of professional medical opinions, you chose what is best for you.

One thing I will mentioned is try to have the Decipher test done, PSMA and a bone scan.
Decipher will define the risk of your cancer metastasizing. You mentioned having intermediate. That was my initial prognosis but after Decipher was reduced to low risk. My Gleason worst score was 3+4=7.
PSMA will show if cancer confined to prostrate.
Bone scan will determined if spread to bones.

I did not know about Mayo Clinic Connect (MCC) back when I started researching treatments. I learned about these additional test through MCC. if I had known about them I would have asked for them right away. I did have all of them done but would have really helped knowing about them initially.

Good luck!