Brian, Very interesting…in the most recent 2019 article it does stress that there must be “clear macroscopic evidence” of disease in order to know where to place the barrier (between IT and the rectum). My PET was clear.
Also, you can’t unwittingly displace unseen cancer cells posteriorly toward the rectum with the gel- thereby blocking the radiation attempting to hit it.
My RO went over this with me - not in the same detail, however - when I asked about it; and the last thing I wanted was rogue cells being protected by s barrier and getting away from the path of the beam.
Don’t get me wrong, I am still very concerned about possible future toxicities, but I was very strict in my adherence to dietary guidelines and they were checking for gas before every session so I just closed my eyes and hoped for the best.