Prostate cancer and protons forge lasting brotherhood

Proton therapy advocate Bob Marckini calls it the “Brotherhood of the Balloon.” It’s the lasting bond of fellowship forged among men who, day after day, come to know one another as they wait their turn to have their prostate cancer zapped by protons.

Wisconsin resident Bill Friedlander found the camaraderie among prostate cancer patients one of the most rewarding aspects of his proton treatments earlier this year at CDH Proton Center, A ProCure Center, in Warrenville, Illinois.

“Marckini reflected this in the book he wrote,” Friedlander recalled. “The social aspects of treatment play a tremendous role in your everyday well-being.”

Their shared cancer and the rather immodest patient preparation that all prostate patients endure instantly erased any distinctions of status, education and economic class, observed Friedlander. “You were among people from all walks of life, from guys who drive trucks to farmers to company executives. Prostate cancer and proton therapy were the great equalizers.”

Everyone goes through the same routine, Friedlander noted. Each man drinks 24 ounces of water — just enough water to fill his bladder and hold it still during treatment. They visit the changing room to shed their street clothes and don an open-backed patient gown and comfortable robe.

In the treatment room, each patient lies on his back on a treatment table. A balloon is inserted into his rectum and inflated with 120 cubic centimeters of water. An X-ray is taken. Three tiny gold coils, planted into the prostate during pre-treatment preparation, read white on the X-ray. They provide visual reference points to help the radiation technician nudge the patient on the treatment table to within 2 millimeters of where the beam will be targeted in the prostate.

Prep for treatment takes about 30 minutes. “And there is no modesty,” Friedlander said with a chuckle. In a nod to Danté’s Divine Comedy, Friedlander said an appropriate sign above the proton treatment room doorway could announce, “Abandon modesty, all ye who enter here.”

“There was all sorts of jocularity and fun and truly getting to know one another,” he recalled fondly. “Every day. Five days a week. It was kind of a fraternity in that sense.”

Friedlander and his spouse were greeted by about a half dozen men and their wives when he started treatment in late April 2013. They welcomed the newcomers with warmth and good humor, each offering their own views of the daily treatment routine, the technicians they liked and where to eat in the Chicago suburbs.

As the morning routines commenced, the group of men grew to 10 or 12. Over the next nine weeks of his own proton beam therapy, Friedlander saw newfound friends rotate out of the group, having completed their 44 rounds of therapy, and a new set of patients — and soon to be friends — rotate in. With no television to distract them, conversation among the patients and their wives was sincere and spontaneous.

“One of the first things you say to one another is, ‘What number [treatment] are you on?’” Friedlander said. Early on, patients with treatments in the double-digits played mentor to the new prostate patient from Wisconsin. Later, Friedlander offered supportive guidance to the newly arrived patients.

“You feel a little superior because you’ve had your 35 treatments and you have only 9 to go,” Friedlander observed with a laugh. “Seriously though, you try to counsel the new people, ‘You’ll be settling into a routine. You’ll be amazed how fast it goes.’”

The word “cancer” was never spoken. “It was always, ‘What’s your Gleason?’ or ‘What’s your PSA?’” he said.

Every week, CDH Proton Center holds a graduation ceremony for all cancer patients who have just completed their treatments.

“At my graduation, there were 11 of us,” Friedlander said. “They give all the graduates a chance to speak. But 90 percent of the guys couldn’t finish. They were so emotional. I think a lot of these fellows really thought they were going to die when they were first diagnosed. And they were overcome with emotion over the friendships they had formed and that they were all cancer survivors.”