SpaceOAR: Good or Bad

[Danskor]

Newly diagnosed in June with aggressive prostate cancer. I will start 28 sessions of EBRT soon. I have been seeing two different RadOncs. I thought SpaceOAR was standard procedure. One of the ROs is also professor with over 30 years experience in the field of PCa and does not allow it to be done at her medical college because she has seen rectal and other medical issues with the use of SpaceOAR and has even written a medical paper on that subject. That information sure was a surprise to me. The other RO uses SpaceOAR routinely and says he does not encounter problems with the procedure. Due to the aggressive nature of my PCa ,I want to start radiation soon and could start sims with the first RO in about 10 days. This is turning into a real dilemma for me as avoiding rectal issues,if possible, is a priority for me. I would appreciate thoughts from anyone with knowledge or experience with the procedure. Thanks.

[flying49]

I was diagnosed 5years ago with advanced pc at 68. I had 45 radiation rounds and ADT with Lucrin in Oz. MY urologist recommended SpaceOAR and after researching it I went with it as I felt the added protection was worth itI am well and have had no adverse effects from the SpaceOAR

I was told I would survive 5years and from there on it would be a bonus (my warranty just ran out so off into the bonus rounds). I would recommend SpaceOAR as I think you need every edge you can get. Good luck

[tango65]

This is a list of articles published about SpaceOAr

pubmed.ncbi.nlm.nih.gov/?te...

This is a list of articles searching for hydrogel and radiotherapy:

pubmed.ncbi.nlm.nih.gov/?te...

This study found 3% grade 3 complications caused by the hydrogel.

pubmed.ncbi.nlm.nih.gov/358...

[Danskor in reply to tango65]

Great information. Thank you.Danskor

[timotur]

I had SO with HDR-BT, no issues at all. Just make sure you get a Dr that has placed several hundred of them.

[Tall_Allen]

I agree with the RO who does not want to use it. IMO, it should never be used with Stage 3. In addition to the risk of rectal injury from the gel, there is a risk that the gel will envelope the EPE, protecting the cancer from getting irradiated. This is what happened to a friend of mine. The inoperable tumor grew into his rectal wall causing pain and obstruction.

It does not prevent acute rectal injury at all. Its only effect is on late-term rectal injury, but that occurs in only about 2% of men getting EBRT. I consider it a cure in search of a disease.

prostatecancer.news/2017/01...

You may be interested in why they refused to allow it Canada:

muhc.ca/sites/default/files...

[Danskor in reply to Tall_Allen]

Thank you so much for replying to my posts. I believe your knowledge has been very beneficial to the gentlemen on this site, myself included.

[TylexGP in reply to Tall_Allen]

My RO recommended against space oar due to the location of my PCA and epe.

[Don_1213 in reply to Tall_Allen]

My RO nixed space-oar and gold fiducials. His feeling was with G10 disease, contained to the prostate, he didn't want to "stir things up" - ie - release PCa seed cells. I did have some grade-1 sort of rectal side-effects (hard, small poop) but that cleared up when I started LDN (Low-Dose-Naltrexone) - really overnight. He also said the gold fiducials can make the treatment techs lazy and while you can grossly aim the beam with them, they can get displaced from the actual tumor, making the treatment less effective.

With the treatment I was receiving there were cone-Xrays taken immediately at the start of each treatment session, and those were used in real time to align the beam to the tumor and shape it.

[Hidden]

I can’t answer your question. I can only share about me after Brachytherapy and 25 sessions of IMRT from 2003. My Radiation Oncologist as the time was a researcher and Professor at Baylor College of Medicine, now the same at Weill Cornell. At the time there were only three IMRT machines in the US; he was on the team that pioneered IMRT.

He used a rectal balloon that he could inflate with saline to protect the colon. He and his team still use the same technique. Result, my Gastroenterologist remarked, “light scarring on the right side of the colon.” He was very surprised after doing countless colonoscopies on men who has received radiation for the prostate.

I still do not have any problems stemming from the radiation. I wish you well.

GD

[ReMarcAble]

I had a horrible experience with SpaceOAR. I believe it was mostly due to lack of experience on the part of the Dr. installing it. I had an almost immediate loss of bladder control and increased ED. It took a few months to get back to normal for me. I really like the concept but the implementation was sketchy at best

[lowT163]

personally my cancer went in the direction of the rectum so it had to be hit with radiation. I get a little bleeding if I don’t keep my bowel movements right. No hard or soft movements and no gas. Yep it bleeds sometimes.

[BL2023]

Who was your RO that advised against it? What did you decide re spaceoar and why? I hope you're doing well and thanks in advance.

[Danskor in reply to BL2023]

My RO was Dr. Colleen Lawton. She is a professor at the Medical College of Wisconsin. She is the author of a paper pointing out problems with SpaceOAR.I was under pressure at the time (Dec. ,2022) to make a decision. I found research both for and against. I found an article (can't remember where) about a comprehensive study that showed SpaceOAR improved outcomes by 7% . I decided to go with the SpaceOAR. It was a decision based on percentages.

For me, SpaceOAR was the right decision. No side effects at all.

Try to find a Dr. that has done the procedure many times.

Best wishes. I hope things turn out well for you.

[BL2023 in reply to Danskor]

Thanks for the reply!

[TylexGP]

I had HDR- BT followed by EBRT without SpaceOar. I am almost two years out from the HDR-BT with no rectal issues from not having SpaceOar!