10 - 11 January, 2008

Greetings to all.  Today was beautiful and sunny, altho, as the day went on, the smog bank came up the valley from Los Angeles.

Today I'll go thru some of the treatment procedures and equipment.

This is the first time using pictures and it turns out that I needed to load the last picture first so they would be in the correct order. Rather than doing it all over again (I had difficulty uploading due to bandwidth problems), You, the reader will need to adhere to "the last shall be first and the first shall be last".  Therefore the 1st picture is at the bottom right.

In the first picture, you see the "pod" on a 3-axis table that can be very finely adjusted to get me into precisely the correct position relative to the beam.  The pod resembles an 18" diameter tube cut in 1/2 lengthwise. A fresh sheet is draped over the pod each time.  Using the step, I climb into the pod (while wearing one of those wonderful hospital gowns!!). The black object on the other side of the pod is an x-ray machine. Once in  the pod, I roll over onto my left side so that a balloon can be can be inserted into the rectum (thus the "Brotherhood of the Balloon").  This balloon is then filled with water.  The purpose for this is two-fold - it helps to stabilize the prostate and it moves the posterior wall of the rectum away from the proton path.  I will also have drunk 2 - 2 1/2 glasses of water to move the bladder wall from the proton path and to aid in stabilizing the position of the prostate.

Once this is finished, then I roll onto my back and a radiation tech will position me in the pod (2nd Pic).  The pod (with me in it :)) is then moved into position using reference marks on the pod.  The x-ray machine is rotated to a position above me and a picture taken. This is used to accurately refine the pod's position. 

 

The gantry (about 90 tons) is then rotated so that the proton beam controller is at either my right or my left hip (3rd pic). This alternates each day. At this time, the techs then place an aperture (the round metal object on the left in 4th pic) at the front end (the end closest to me). This is custom made for each person and it controls the shape of the proton beam as determined by the shape and position of the prostate and the known prostate cancer site. Then the "Bolus" (the blue object on the right in the 4th pic) is placed in front of that.  This is also custom made for each person.  This determines the proton beam's penetration depth into the body. The other thing that determines the depth at which the proton gives up its energy is the energy of the proton itself which ranges from 175 Mev (Million electron volts) up to 250 Mev.  Those with greater energy will penetrate farther and give up their energy deeper into the prostrate.

There there is also a metal spoked wheel that spins while the proton beam is on. The spokes are about 2 1/2" wide and are tapered lie a knife.  As it spins, it variably attenuates the beam so that the bean will move alternately get longer and shorter.

Well, I've got to get going.  I'll look this over later to see what I may have left out and ad it next time.

God bless  have a happy Sabbath.