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Recent Proton Experience?

Posted by docwatson @docwatson, Aug 31, 2025

Six years ago I was treated with proton at Mayo PHX 😁. Age 68, Gleason 7, PSA 11 (now 0.2 😁😁). I am part of a support group that offers our experiences, however I’m afraid mine is now dated. I got 43 treatments, I understand standard is now 25. Back then they used balloons 🤪, I understand now they don’t but the water/bladder prep is tricky. Everyone’s case is different, but can someone provide a recent (last year or so) experience with the current protocol? Thanks in advance!

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heavyphil | @heavyphil | Sep 1, 2025
In reply to @brianjarvis "The endorectal balloon made sense in its day, (“You go to war with the army you..." + (show)
Profile picture for brianjarvis @brianjarvis

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……

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Brian, you said it all right there!
Phil

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docwatson | @docwatson | Sep 1, 2025
In reply to @daveinflorida "I just finish proton RT in May and because of the location of my tumor a..." + (show)
Profile picture for daveinflorida @daveinflorida

I just finish proton RT in May and because of the location of my tumor a gel spacer could not be used, so I had the balloon. Although certainly not terrible, it was the most uncomfortable part of the whole treatment. I was talking to the technicians one day and asked about balloons and they said probably 50% of their patients used them. I was surprised as I thought gels were more common now.

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That’s an interesting comment about percentage use, thanks. I have to admit that the balloon experience wasn’t physically uncomfortable, it just took a couple times to get over the mental experience,…especially since the RO techs were sometimes attractive ( and skilled) young women! They were great and very respectful.

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jc76 | @jc76 | Sep 1, 2025
In reply to @thmssllvn "...is the proton technique on third party pay? Is longer lasting Space Oar [Vue] now the..." + (show)
Profile picture for thmssllvn @thmssllvn

...is the proton technique on third party pay? Is longer lasting Space Oar [Vue] now the preferred method along with fluid filling of bladder before each session?

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@thmssllvn
Was your question out for anyone on group or were you asking someone specifically? I can pass on my experience with your questions.

Can I ask what you mean by proton technique on third party pay? Proton therapy is still radiation therapy. It just uses a type of radiation that does not enter the body full dose and does not exit the body at all like photon does. It can be programmed to stop at a precise location release it's full energy and then stop. Photon radiation cannot do this.

It is why it is used for brain, eye, etc. treatments and children. The basis is to keep the damage to other tissues and organs to a minimum. Secondary cancers can also come from radiation treatments and since children live very long lives past their treatments secondary cancers can be a more significant risk. This comes from my UFHPTI R/O and my same questions on this. I asked the question when I saw so many children at UFHPTI (proton) versus Mayo Jacksonville which at present only has photon radiation.

Space/Oar is long lasting lasting months after treatments end. It slowly dissolves. I don't know if more improvement over balloon separation but sure helps speed up treatment as the time to do the balloon procedure is removed. The drinking of water is also used to move bladder away.

Now what have I learned since my treatments ended. My Mayo PCP says research is underway to see if there is a significant improvement to side affects damage from those who have Space/Oar and drink water prior to treatments versus those who don't.

It is being done to see if the time, stress, and inconvenience of doing these procedures is worth the significant improvement in side affects if they are not done. This comes from my Mayo PCP doing one of his consultations with me.

I am lucky to have a dedicated PCP who is constantly researching and sudying prostate cancer diagnoses, and treatments. He told me when I inquired he said: "so I can accurately provide advise and information to my patients."

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