insurance denied space oar

[Tomatogardener]

husband was scheduled for space oar placement and had to cancel at the last minute because insurance wouldn’t pay. So how has everyone done that had radiation without the space oar? Many instances of proctitis or diarrhea? How about long term?

[treedown]

I did not have it. No immediate problems and going on 3 years post and nothing yet. I had 44 IMRT sessions 80gy up to aortic bifurcation.

[Doseydoe]

I had 20 VMAT radio sessions targeting my pelvis, bladder and prostate. I was assured I didn't need the space oar. It proved to be correct. Its been two years now and fingers crossed, still no side effects DD 😎

[doc1947g in reply to Doseydoe]

I am the same. VMAT-RT 3 Gy X 20 fx = 60 Gy in June 2020 with ADT for 24weeks (2020/05/31)+(2020/08/24 )Lupron Depot 22.5mg/12weeks X 2 = 45 mg/24weeks.

PSA as of Dec. 5th 2022 = 0.05 μg/L . 20.4 (2020/04/06), NADIR = <0.01 μg/L (2021/02/11).

No Space Oar, neither BrachyTherapy because they involved a Trendelenburg position (Head = DOWN & Feet = UP.

I have cardiac problems and respiratory problems(COPD) so that position is dangerous for mr.

[Burk]

I had 60 Gy EBRT in 20 fractions. No Space Oar. No permanent SE other than no prostate function!

[TylexGP]

I had HDR Brachytherapy followed by EBRT without space oar and only had some diarrhea at the end of EBRT which quickly resolved after EBRT ended. I would not stress too much about not having the space oar.

[Hidden]

It's a money grab by a big pharma company. I had it and my insurance paid for it but I don't think it did anything but make someone richer.

[Jancapper]

I concur with the other comments. My RO did recommend the use of this product. It was placed during my HDBT session 3 weeks ago. After placement of the needle and ensuing verification that it was in the correct location, the syringe clogged. Only 3 ml out of the desired 10 ml was inserted. My doctor commented in my record that he aborted any further insertion of the gel since the HDBT + IMRT was unlikely to cause any long term side effects.

[Tall_Allen]

I didn't have it. IMO the benefit is minimal. It is oversold to patients and doctors.

[Hidden]

Wondering about your 'cheap' insurance. Medicare Advantage or Supplemental?

[Hidden]

I had Brachytherapy followed by 25 sessions of IMRT in 2003. The RO that did the IMRT used and still uses a recital balloon that was inflated with saline to keep the prostate in the same location each time. I only had very light scarring on the left side of my colon. Pioneered by Dr E Brian Butler at Baylor College of Medicine; now with Weill-Cornell. Zero problems. Best of luck.

GD

[Hawk56]

I had SRT in March 2016, 39 IMRT using a Rapid Arc machine, no side affects then or to this date. I also had 25 IMRT to the PLNs in July 17, 45 Gya, no issues there either. My radiologist and her team are very good, she showed me the treatment plan in both cases using her laptop and the 3D software, pretty amazing stuff, each treatment began with imaging to determine the exact position of organs, as the Rapid Arc rotated around and "fired" its beams, each beam was a specific time, "length, angle...all designed to avoid or minimize any damage outside the treatment field.

The technology for both planning and delivery of the radiation treatment is pretty advanced in the hands of a skilled radiologist and their team.

[lowT163]

I think it has a lot to do with the location of your tumor and size. More radiation you need and closer it is to the rectum say hello to the proctitus. I have it but mostly controlled by eating plenty of fiber and avoiding hard stools or gas. Metimusel is my favorite medication.

[VCinTx]

I did have the SpaceOar procedure. This procedure was done at the same time that my "Fiducial markers" were inserted into my prostate. I would appeal the insurance decision as Dr. Mark Scholz has recommended this procedure to protect the rectum.

[raoulmaher]

Hello was offered spaceoar before radiation for about £75 uk but was told after evacuating my bowel with an enema before each dose and drinking copious amounts of water that all would be pretty good on the table so to speak - and actually for the uk - I am doing quite well still need to urinate frequently at night and bowel movement although initial was urgent all the time - this also appears to have settled down !!!! - hope this helps - kindest raoul

[cancerfox]

Yes after 25 IMRT sessions and LDBrachy with no space oar. Loose stools and OAB still an issue after radiation should have dissipated from LDBrachy 9 months ago. Maybe largely due to the LDBrachy though. 🦊

[groundhogy]

My Radiologist had a thoughtful remark when this topic came up.

He said some docs order it every time. He does not. Its a case-by-case basis.

If you are in the higher risk category (risk of micro-mets and recurrance), he said he doesn’t like to use the gel. It can move the micro-mets further from the shooting range and may protect them.

[RMontana]

Tomatogardener, I had sRT (salvage) at 68Gy without space oar as I had no prostate between which the gel could be lodged and protect my colon...I dont know from your writing if that is the situation with you husband; has he had a RP and has no prostate? But at 68Gy which is low radiation I had the full 35 sessions and had no problems. The key for me was to have a completely empty colon each day of treatment. I choose the very first appointment of the day at 6:30am...that way I stopped eating the day prior at no later than 5pm and had all night to evacuate. On days when I missed evacuating my food I have myself a warm water enema; that works right away! But on the day of the treatment if your husband has any feces in his colon the team 'should not' treat, but if its 'close' they proceed...a few close sessions could irritate the colon and that is where you have problems.

So, yes you can have radiation to the pelvic area without space oar and have good results; I have no symptoms. But the key is to have complete empty bowels and I mean empty...good luck and let us know what happens...TNX Rick