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Prostate Cancer | Last Active: Sep 1, 2025 | Replies (23)
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The balloon actually makes no sense to me: it inflates the diameter of the rectum, swelling the walls outward and closer to the beams.
So maybe the inner epithelium might get spared - depending on the direction of the beam, but I would think the outer tissue would be more vulnerable. The Gel Spacer is at least between the gland and the rectum - that kind of barrier makes sense.
Yes, proton advocates like to say that their technology is more precise, but there are plenty of SE’s reported in the literature ( though possibly less).
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The endorectal balloon made sense in its day, (“You go to war with the army you have, not the army you wish you had.”) It was the best they had 10+ years ago.
With FDA-approval of SpaceOAR in 2015 (and Barrigel in 2022, and BioProtect in 2023), you’d think that they all would’ve migrated to one of the other spacers by now.
But, even with prostate biopsies, some centers are still doing transrectal biopsies, even though transperineal biopsies are clearly superior.
It takes years to get a good idea into medicine; it takes twice as long to get an old idea out of medicine……