Rectal Toxicity


External beam radiation therapy (EBRT) is the treatment of choice for patients with localized prostate cancer. It is highly effective in killing prostate cancer cells, but a potential side effect is rectal toxicity due to the proximity of the prostate to the rectum. Rectal toxicity is associated with the following symptoms, which can be short- or long-term:

  • Diarrhea
  • Mucus discharge
  • Rectal bleeding
  • Rectal leaking
  • Rectal pain
  • Fecal incontinence
  • Fecal urgency

Recent technological advancements have led to modern radiation therapies such as Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT), which improve treatment accuracy and effectiveness. However, parts of the ventral rectal wall are still frequently exposed to high radiation doses.

The bottom line: Grade 2 (G2) acute proctitis occurs in up to 35% of radiation-treated prostate cancer patients.




The higher the dose, the more effective the treatment, but…

Clinical studies have shown that dose escalation can limit cancer recurrence and improve overall treatment success.



Novel radiotherapy modalities such as hypofractionation reduces the number of daily fractions (from over 40 to less than 20), while increasing the daily dose.

Since prostate cancer is highly sensitive to fraction size, hypofractionation could become the standard of care for localized prostate cancer, making EBRT a more cost-effective and attractive treatment modality, with a profound impact on patient quality of life.

However, an increase in daily dose could cause even more extensive damage to surrounding healthy tissue.


With the BioProtect Spacer, safe dose escalation and hypofractionation are finally a safe reality!

When using a higher radiation dose, the need for a separator that shifts the rectum away from harmful radiation is paramount. The BioProtect Spacer, a biodegradable balloon implant, enables dose escalation and hypofractionation while reducing proctitis-related complications to a minimum.