Consulted by video with the doctor who is supposed to install my SpaceOAR in preparation for my IMRT. His first words were "we don't use SpaceOAR gel anymore. We use Barrigel." He explains it has fewer side effects but the same radiation absorption characteristics. Here is what "UroToday" says:
"Barrigel, which allows more time to create symmetrical spacing and has a shorter learning curve for trainees. Barrigel also has a lower risk of rectal wall invasion and is more comfortable for patients. The Barrigel trial showed a significant reduction in toxicity in the first three months compared to the SpaceOAR trial, which showed toxicity reduction after 18 months. They emphasize the importance of symmetry in spacing for optimal radiation therapy outcomes. The take-home message is that Barrigel provides greater control and safety in rectal spacing during radiation therapy for prostate cancer patients."
The procedure will be scheduled in April. IMRT is scheduled for May. The doctor explained the procedure needs no prep (maybe an enema of the lower bowel) and he anesthetizes the insertion region while administering laughing gas. Takes about 30 minutes and I can drive myself home. I liked the doctor, had detailed answers for all of my questions. The gel lasts approximately 6 mos. and the IMRT should commence within 2-3 weeks of procedure. Statistically, almost 10% of patients develop significant bowel irritation over several years from EBRT. He said sometimes effects don't show up for up to 8 years. A spacer gel cuts the occurrence to just over 2%. For me that's a significant reduction and well worth any risks from the procedure, so I'm signing up.
BTW, finished my first week of Orgovyx. No manifest SEs to report, but I feel different--not for the good.
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mababa
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I had a Barrigel inserted a month ago. It was very straightforward. The Barrigel shows up more clearly on ultrasound as a dark area. I could watch the gel being placed in position. I just had a local anaesthetic and did not feel any discomfort afterwards. It's a good option for the reasons you outline.
I had 28 rounds of Pelvic area radiation, finishing about 6 weeks ago. The Onocology center I went to uses SPACEOAR. It was uncomfortable being put in, but the results were readily apparent after the radiation treatments started.
There was a small group of us that had radiation treatments around the same time, Most of us were usually a bit early, and the center had 2 LINAC machines with CT scanners built in. We discussed our treatments and side effects as we waited for our turn. The folks that did not have spacers installed seemed to be getting bowel issues quicker than those of us that did. I do think that all of us eventually got some bowel cramping if we had the spacer or not. From a personal viewpoint, I had very little bowel issues.
Honestly if someone is just starting this journey it does appear (at least to me and the folks that I went thru my journey with) that a spacer, BARRIGEL, or SPACEOAR is a good investment in yourself before you start the radiation.
I had a barrier put in also. I don't know what type. It was a bit more uncomfortable than a biopsy but only for a second. I still experienced lower bowel issues. Its been 3 months since the RT and things are getting better but I my rectum is damaged. I now question its efficacy.
I share your concerns. No matter the care taken, radiation—pellets or EBRT—will cause some necrosis of surrounding tissue in a manner similar to advanced aging. SEs are just delayed which, I guess, is a good thing. But placing the spacer will ease some anxiety, although the urethra will still be vulnerable.
Well, that was quite the string of posts re Break60. Thanks, J, for more illumination on the subject. I've also thought about chucking the notion of EBRT and just sticking to intermittent ADT as a measure of slowing my PCa. As we all come to terms with PCa, there's no simple solution. My RO won't like the "postpone" option, but I may run it past her. EBRT has indeed come a long way. This really could mitigate side effects. Also noted and is very true, we read the worst of the results on this site, for obvious reasons. Best to remind ourselves of the statistics regarding the long term side effects from EBRT. I need to chase those down.
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