I had similar treatments at the University of Cincinnati’s proton center in Liberty Township - 28 fractions of proton radiation @ 2.5 grays per fraction. I used the SpaceOAR Vue gel; didn’t use fiducial markers.

It’s not actually ablating the prostate tissue; it’s damaging the DNA in the prostate cells; later when the cancer cells try to divide and multiply, they can’t…..and die. (See attached graphic.)

I only had 1 day of adverse urinary side-effects during treatments. On the 3rd day of treatment, I had difficulty urinating. My RO told me that with some men there’s an inflammatory response to the radiation, and if that inflammation is near the urethra can cause the issues that I was experiencing. He recommended that I take 2 Tamsulosin/day for the remainder of the treatments. Everything cleared up by the next day; I haven’t had any issues since. I had no other adverse urinary side-effects from the radiation treatments.

Using SpaceOAR reduces the risk of radiation-induced hemorrhoidal irritation, mucosal injury, proctitis, and even secondary cancers. SpaceOAR has also been demonstrated to provide improved GU, GI, and sexual benefits.

How is practicing your full bladder/empty bowel routine going? Consistency with that will help your outcome.

Will they be avoiding radiating your penile bulb? Data show that late ED may be avoided by minimizing radiation hitting the penile bulb —> https://www.icr.ac.uk/about-us/icr-news/detail/avoiding-penile-bulb-with-radiotherapy-could-save-men-with-prostate-cancer-from-harmful-side-effects

I was on active surveillance for 9 years and spent the last 3 of those years researching treatment options and facilities. By the time I chose to have treatments, I had no doubt that I had made the best choice for me.

If you’ve taken all necessary precautions, pull the trigger.

(I live in the Dayton area; if you’d like to get together mid-way between our locations to discuss what’s on your mind, we can arrange that.)