The treatment process

For those that are interested in what is involved in the proton treatments, this is what it’s like.

First, all treatment patients are given a time to receive treatment anywhere from 5AM to 11 PM. Since there are always patients completing their treatment plans, there are time slots that come up throughout those times. My treatment times have all been in the evening, except for my initial treatment which was at 9:30 AM. A patient is given a specific time, but are requested to be there 30 minutes early in the event they are ahead of schedule, which they often are. You check into the waiting room with the receptionist and are called back when they are ready.

The first step in the treatment is to go into the changing room, undress and change into a hospital gown. Yes, one that opens in the back and doesn’t have buttons, strips, or Velcro to close it. Yes, they are still drafty. They all have strings that are too short. They still haven't improved on the hospital gowns since the time of Florence Nightengale they've been stuck on the same style.

You then go to a room that is somewhat like the transport room on the Star Wars set. On one side of the room there are computers, screens, monitors, and other types of display systems. On the other side is what looks like the inside of a huge washing machine about 10’ in diameter on its side without the agitator in the middle. Or, if this makes it more palatable, visualize this; think of the inside of a donut with white smooth frosting on the inside. It really has nothing to do with a washing machine or a donut, it only reminds me of one.

There is a large sliding mechanism (think of a maple bar if this helps) where they put you into this form that holds a half piece of PVC pipe about 24” in diameter and 7’ long that slides into the large washing machine / donut looking thing. Each patient has their own half tube as it is form-fitted to each person. On my initial visit they put a piece of plastic sheeting in the tube and had me lie down in it. They then poured quick setting foam into it to fill in any of the void area. This way it is formed fitted and helps them to align your body consistently each treatment.

There is a gray plastic 2’ square screen on the left which I imagine is some type of lead shield and a metal camera lens looking thing on the opposite side. That’s the thing where the protons are actually emitted from. Both of these things rotate from side to side daily so the treatment is given equally. It’s different than other radiation treatment machines where there is only minimal room when you go into a tube-like machine. In this case if I reached out to touch the sides I’d still be about 4’ short of reaching them.

There are 4 technicians in lab coats that manage varying parts of the procedure; putting the form in place, adjusting a patients hips for proper alignment, lining up the proton nozzle, calibrating the instruments, and checking for proper dosage, etc.

They then slip this lead shield type thing into the front of the nozzle that is the same size and shape as the patients prostate. I must say I think that I have a superior shape prostate. It kind of looks like a walnut. The purpose of this thing is to assure that the proton radiation is focused only on a specific area.

During this time the techs are telling you a joke or talking about things that are going on in their lives.

It's just like getting x-rays taken at the dentists office except for the fact that you're getting it done without any clothes on and you're bare naked lying in a coffin-like molded plastic piece of half-rounded PVC pipe and they aren't aiming anything at your mouth.
Also, there are bright red lights that cast a specific line of light to ensure that you are aligned correctly.

The techs disappear behind a lead screen in an enclosed room and a machine starts up that makes a whirring sound. From some place in the room you can hear a beeping sound that signifies the fact that there is proton radiation being emitted. After about two minutes all the whirring, beeping, and humming ceases and the techs come back into the room. You’re free to climb out of the thing and go into another room and put your clothes on while the next guy goes through the same process.

So, it's not painful or invasive, only humiliating, embarrassing, and drafty. I take that back, it is invasive. Think a colonoscopy that they don't put you out for. It's a good thing that I have a high tolerance for embarrassment. Clothes off to clothes on? About 15-20 minutes which leaves about 23 hours 40-45 minutes to actually shop for those donuts.

I guess with some guys there's a minor incontinence problem. In fact, someone that had the treatment put together a flyer that lists all the public bathrooms within a 5 mile radius of the hospital. I’m going to improve it by mapping all the trees too.