Inclusion Criteria:  Age 18 or older Informed consent for treatment and study participation completed Pathologically proven diagnosis of prostate adenocarcinoma ECOG Performance Status 0-2 No prior history of pelvic radiotherapy, brachytherapy, cryosurgery, HIFU, TURP or radical prostatectomy  Exclusion Criteria:  Presence of nodal or distant metastasis on staging MRI or CT Abdomen/Pelvis and Bone scan within 90 days of enrolment (CT/MRI/Bone Scan are only required if the clinical risk of metastatic disease is sufficient to warrant these scans) Plan for adjuvant chemotherapy post-radiotherapy Serious medical comorbidities or other contraindications to HDR brachytherapy Presence of inflammatory bowel disease Presence of connective tissue disorder seen as a contraindication to radiotherapy Medically unfit for general/spinal anesthesia Unable or unwilling to complete questionnaires