Dose-Escalated Proton Radiation Therapy for High-Risk Prostate Cancer

Inclusion Criteria: * Patient must give study-specific informed consent on an IRB-approved consent prior to any research related procedures or study treatment. * Patient must be at least 18 years at the time of consent. * Adenocarcinoma of the prostate with AJCC Clinical Stage T1to T3b disease with histological evaluation via biopsy or repeat biopsy within 12 months prior to registration. * Patients must undergo a pretreatment diagnostic MRI of the prostate on a 1.5T to 3T Tesla machine within 6 months prior to study registration. * A focal IPT must be visible on MRI within the prostate and/or seminal vesicles and this MRI must be obtained within 6 months of planning CT scan. * A biopsy of the dominant lesion is recommended but not required. If an ultrasound guided sextant biopsy was positive for prostatic adenocarcinoma in the area of the MRI identified intraprostatic lesion, this will be acceptable and another guided biopsy targeting the MRI identified disease will not be necessary. * Patients with at least one of the following high-risk factors: cT3a-T3b OR Gleason 9-10 OR PSA \> 30 OR more than 1 high-risk factors must be present: clinical stage of T3, Gleason score 8-10, or PSA 20 ng/ml or greater. * Hemoglobin must be ≥ 10 g/ml within 4 months prior to registration. * Zubrod performance status must be 0-1 within 4 months prior to registration. * If patient has child-producing potential, they must be willing to use medically acceptable contraception during treatment and…