Recent Proton Experience?

What do you mean by they used balloons? What did they use them for?

The current protocol is that they use more radiation in every treatment. I know a few people that have had urinary and rectal problems due to the higher amount of radiation. In some cases, that number of treatments has been increased and radiation reduced because of the side effects. That is quite uncommon, Most people have no problem with the increased radiation and fewer treatments.

Sure is great that Mayo Clinic has proton radiation. This will probably become the standard in five or so years since it’s much cheaper to build the machines. It used to require a new building now they just require a room or two.

Water is a very effective radiation shield. Protons and photons lose energy when passing through water. It's a rectal balloon that move the rectum further away from the radiation field and stabilizes it positionally.

You mean the barriers like SpaceOAR, Barrigel, or BioProtect?

jeffmarc, no. It's an old long before Space Oar. It really is a water balloon that they insert and fill before each radiation fraction. It isn't a surgical placement.
Rectal balloons are still in use, though.

No, more like the attached image. I’m glad you mentioned space or, I also had that inserted… Surgically between the rectum and the prostate, done when I had the markers installed for treatment.

The story I heard was that in the early 90s at Loma Linda a nurse went to the local drugstore and bought all the condoms they had and invented this process.😉

docwatson, don't blame the nurse it was the dosimetrist.

When I had proton radiation treatments in April 2021, my RO had never used SpaceOAR; he had only used endorectal balloons. (So, I connected him with Boston Scientific to get the product in.) I was his first.

SpaceOAR Hydrogel was FDA-approved in 2015; an improved version (SpaceOAR Vue) was FDA-approved in 2019. Barrigel was FDA-approved in 2022. BioProtect was FDA-approved in 2023.

Clinical data showed that SpaceOAR offered improved benefits when compared to the older endorectal balloons: https://www.urologytimes.com/view/hydrogel-spacer-lowers-rectal-bleeding-vs-balloon-immobilization-treatment

My oldest brother — 79y, PSA 5.7, Gleason 4+3=7 — has just completed 19 of his 28 IMRT treatments. His full bladder/empty bowel routine was the same as mine during my proton radiation treatments (April-May 2021),

For me, that was just 18oz of water to drink just 30 minutes prior to each fraction. I emptied my bladder/bowels 45 minutes prior to treatment time, started the 40 minute drive to the radiation center, 10 minutes into the drive drank 18oz of water, arrived at the treatment center 30 minutes later, and had the treatments. Worked every time; never had a problem.

@docwatson
My treatment was finished 2.5 years ago so I am outside the last year you wanted feedback from.

I had my proton radiation at UFHPTI as Mayo Jacksonville could only offer Photon. Mayo wanted to do 20 rounds of photon radiation. UHFPTI wanted to do 30 rounds of proton radiation. I think the medical providers decide the appropriate number of treatments based on your individual prostate diagnosis and test done.

The number of treatments you get is based on your cancer, your treatments, and your doctors and R/Os determination. I know at UFHPTI the treatments go through their physics department to specifically tailor the number and type of radiation treatments for you as individual.

I do know my PCP and UFHPTI R/O both said research was showing more side affects and sooner for the high dose shorter number of treatments.

You mentioned balloons. Not sure why you got negative feedback on the use of balloons. That is very common method of moving colon away from prostate for those who do not have Space/Oar done. And you are correct were being done prior to things like Space/Oar and their use continued to today who don't want Space/Oar or for other reasons could not have the Space/Oar procedure done.

UFHPTI used baloons on those who did not have Space/Oar done. I know when I finished my proton treatments and was getting up from my treatment bed I could see the tech setting up the insertion of the balloon for next patient. He must have been had the same next time after mine as saw this each time.

The balloon and SpaceOar are done to help move colon away from prostate. Like drinking water is to help move bladder away. I am glad I had Space/Oar only because it really sped up my treatments. I do remember getting a balloon during My MRI with contrast and was done to provide a better picture.