The Proton Therapy Experience – Part 2

In Part 1, Bobby shared the steps he went through to get started with proton therapy. Read Part 2 below.

Remembering the start

It was Monday, October 19th, 2020. The presidential campaign was in its final weeks. Over 2.5M Coronavirus cases were active in the U.S. that day. That daily number would later eclipse 9M at the peak. And the Dodgers just punched their ticket to the World Series. It was also the beginning of the end of my prostate cancer.

At least that was my attitude as I entered the proton center for my first treatment.

My son drove me, offering much needed moral support. After filling out Covid questionnaires and getting my temperature checked, I was issued a barcoded name badge.

“Can my son watch the treatment?” I asked. The nurse replied, “With Covid, we only allow patients beyond the waiting room. Please scan your badge so they know you are here.” As Covid numbers escalated, restrictions would tighten. Several weeks later, patients only would be allowed in the building.

Prepping for the treatment

Before leaving the house, I did my first morning prep. After a restroom visit, I drank 24 ounces of water. Some 30 minutes later, I was sitting in a socially-distanced waiting room, masked. Soon a tech arrived. “Are you ready?”  Trying to hide my jitters I said, “Let’s do it!”

The first stop was an examining room in which an ultrasound was used to determine bladder contents. Checking my badge for my target range, the tech said, “That looks good, I’ll show you to the dressing room.”

Though I hit the range that day, I wouldn’t always. Sometimes I would be high, and once I was low. Remedying the former is easy – they put a line on a cup and ask you to hit it before treatment. But if you are low, it's back to the waiting room for more water. To avoid that, I drank extra water, roughly 28-32 oz daily. If I was to be off, the fix would be easy.

The treatment rooms

“Put on a gown, everything off from the waist down, but you can keep your shirt on. We will be back shortly.” The treatment rooms, or “gantries,” have two dressing rooms so one patient can be treated while another prepares. The center has 3 gantries, two with fixed tables and a proton-emitting “nozzle” that fully rotates around the table. The third gantry was just the opposite. The nozzle is fixed, but the table moves. That’s the one for prostate patients.

Soon I was on the table. Two foam rubber channels help position your legs. After lying on my back and placing my legs in the channels, the tech “expertly” lifted the gown while covering the groin area with a towel. That exposed all 5 alignment marks, but kept me “covered.”

The table then rotated, placing the left hip next to the nozzle. An X-ray follows, mainly to check bladder and rectum positioning. Usually both are where they need to be, but sometimes they aren’t.

If there is a problem, it is usually the rectum, due to gas expanding it too near the prostate. The gas needs to be “expelled” before a treatment can be administered. It didn’t take long to learn that the best way to deal with that was not to let it happen at all!

Over in a couple minutes

When the techs were satisfied, they left the room and started the treatment. It was over in 1-2 minutes and was completely painless. Just don't move! Then they rotated me 180 degrees, positioning the right hip for the same treatment. After repeating the process, I was done for the day. The next 43 treatments would be identical. As I left the table, the techs returned my badge, prefilled with my next arrival time.

After a while, I began to develop tan marks on both hips. These were monitored weekly by the doctor. Skin problems can occur at the entry points, but I never had any. Six months after completing treatment, the marks had noticeably faded.

Daunting at first

For the next 9 weeks, and even on one Sunday in lieu of Thanksgiving, I trekked to the center. It was daunting at first, but it goes by surprisingly quickly.

After #44, I was finally done and still had no major side effects. But there was one last step: my time to bang the gong had come. "Hit it like you mean it!" she said. I very happily followed my last instruction. Covid even got involved in that; friends and family still couldn’t enter the building, so the ceremony was held outside. That was December 18, 2020.

Christmas had truly come early.