Phase II Study to Evaluate the Safety and Efficacy of Prostatic Artery Embolization

Inclusion Criteria: * Histologically or cytologically confirmed prostate adenocarcinoma in the very low or low or favorable intermediate risk risk stratification groups (i.e. Gleason Grade groups 1 and 2) who are eligible for and who select XRT as their cancer management method. * Ability to receive prostatic artery embolization within 6-12 weeks of definitive radiation therapy. * Ability to understand and the willingness to sign a written informed consent document * Prostate larger than 60 grams but less than 150 grams, as assessed by imaging scans * American Urologic Association (AUA) or International Prostate Symptom Score (IPSS) Score ≥ 15 * Normal organ and marrow function as defined in protocol Exclusion Criteria: * Patients with Gleason Grade Group 1 or 2 PCa who select active surveillance as their cancer management method. * Receiving androgen deprivation therapy (ADT) * Patients with unfavorable intermediate (Gleason Grade Group 3) or high risk localized PCa (Gleason Grade Groups 4 and 5) * Receiving any investigational agents for the explicit purpose of prostatic size reduction * Inability to receive prostatic artery embolization (PAE) within 6-12 weeks of definitive radiation therapy * Active urinary tract infection (UTI) * History of severe allergic reaction to intravenous contrast media (iodinated and gadolinium- based) or any agents used during the PAE; patient cannot be medicated against allergic reaction prior to PAE. * Active cystolithiasis or prostatitis * Inability to have multi-parametric magnetic resonance imaging (mpMRI) * Prior transurethral resection of the prostate (TURP) within 2 years * Prostate size greater than or equal to150 grams * Vulnerable subjects (e.g., inmates and developmentally delayed adults) who are subjects for whom the study may be unsafe or whose rights may be violated with enrollment.