Stereotactic Body Radiation Therapy in Treating Patients With High-Risk Prostate Cancer Undergoing Surgery

Inclusion Criteria: * Histologically confirmed primary non-metastatic adenocarcinoma of the prostate * Patient desires and is medically fit to undergo prostatectomy * Karnofsky performance status (KPS) \>= 70 * Patients on androgen deprivation therapy (ADT) are allowed * For confirmation of high risk local failure status, patients will have any one of the following: * Computed tomography (CT) or magnetic resonance imaging (MRI) demonstrating seminal vesicle invasion (SVI) or extraprostatic extension (EPE) within 1 year of enrollment into the study * Pre-biopsy prostate-specific antigen (PSA) \>= 20 * Gleason score 7-10 (Gleason 7 must be 4+3), presence of any Gleason 5 (even if a tertiary score) as determined at diagnostic biopsy * Gleason score 7 and \> 50% of biopsy cores positive for prostate cancer * Clinical stage \>= T3 (staging by imaging acceptable) * An image-guided biopsy (via Artemis Ultrasound with MRI co-registration) is encouraged but not required if not performed as standard of care biopsy Exclusion Criteria: * Distant metastases, based upon: * CT scan or MRI of the abdomen/pelvis or prostate specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) within 120 days prior to registration and * Bone scan or PSMA PET/CT within 120 days prior to registration; if the bone scan is suspicious, a plain x-ray and/or MRI must be obtained to rule out metastasis prior to registration * Patient is unable or unwilling to si…