Inclusion Criteria:

          -  Histologically confirmed prostate adenocarcinoma (within 365 days of randomization) at
             intermediate risk for reoccurrence determined by at least one of the following:
             Gleason Score 7, PSA > = 10 and < = 20, T stage T2b - T2c

          -  Clinical stages T1-T2c N0 M0 as staged by the treating investigator. (AJCC Criteria
             7th Ed.- appendix III).

          -  Histological evaluation of prostate biopsy with assignment of a Gleason score to the
             biopsy material; Gleason score must be in the range of 2-7. > 6 cores are strongly
             recommended.

          -  PSA values < = 20 ng/ml within 90 days prior to randomization. Obtained prior to
             biopsy or at least 21 days after prostate biopsy.

          -  ECOG performance status 0-1 (appendix II) assessed within 90 days of randomization.

          -  Patients must sign IRB approved study specific informed consent.

          -  Patients must complete all required pre-entry tests listed in section 4.0 within the
             specified time frames.

          -  Patients must be able to start treatment within 56 days of randomization.

          -  Patients must be at least 18 years old.

          -  For brachytherapy, an IPSS ≤ 21, or ≤ 17 if patient is on medications to improve
             urination.

          -  For brachytherapy, prostate volume must be less than 55cc prior to AS.

        Exclusion Criteria:

          -  Pelvic lymph nodes > 1.5 cm in greatest dimension unless the enlarged lymph node is
             biopsied and negative.

          -  Previous prostate cancer surgery to include: prostatectomy, hyperthermia and
             cryosurgery.

          -  Previous pelvic radiation for prostate cancer.

          -  Previous androgen suppression therapy for prostate cancer.

          -  Active rectal diverticulitis, Crohn's disease affecting the rectum or ulcerative
             colitis (non-active diverticulitis and Crohn's disease not affecting the rectum are
             allowed).

          -  Prior systemic chemotherapy for prostate cancer.

          -  History of proximal urethral stricture requiring dilatation.

          -  Current and continuing anticoagulation with warfarin sodium (Coumadin), heparin, low-
             molecular weight heparin, Clopidogrel bisulfate (Plavix), or equivalent (unless it can
             be stopped to manage treatment related toxicity or to have a biopsy if needed).

          -  Major medical, addictive or psychiatric illness which in the investigator's opinion,
             will prevent the consent process, completion of the treatment and/or interfere with
             follow-up. (Consent by legal authorized representative is not permitted for this
             study).

          -  Evidence of any other cancer within the past 5 years and < 50% probability of a 5 year
             survival. (Prior or concurrent diagnosis of basal cell or non-invasive squamous cell
             cancer of the skin is allowed).

          -  History of myocardial infarction within the last 6 months.