SpaceOar Experience

I went to the UNM Cancer Center for the SpaceOar injection on Monday. This was because my local hospital cancer centre doesn’t do the procedure. If it wasn’t for the 120 miles round-trip drive I would have selected the UNM Cancer Center for my radiation treatment as it was 39 zaps. Similarily if it wasn't 750 miles away I would have used MD Anderson. I have consulted with them all over the past 7 months since diagnosis. Instead, I will soon be starting 44 fractions of 79.2 RapidArc® Radiotherapy in Santa Fe at Christus St. Vincent Regional Cancer Center.

SpaceOar is a product which is similar to epoxy but water based that is used to protect the rectum and reduce erectile dysfunction for men receiving radiation treatment for prostate cancer. I thought sharing my experience might be helpful. There are various products available including balloons to reduce radiation dosage to the colon. However, SpaceOar seems to reduce ED which appeals to me.

So, I was placed on a liquid diet the day before the procedure. I also was prescribed a 500 mg Levofloxacin 3 pills one a day along with a Fleet enema- the night before and morning of. Prior to the procedure, I accepted a Xanax 5 mg from the nurse to reduce anxiety. I had some anxiety. Not sure I felt the Xanax. I turned down the Oxycodone as my stomach was bothering me.

Undressed from the waist down and flat on my back on the exam table, I was asked to put my feet in stirrups which spread my legs apart while the technician lifted my legs high in the air. I am on Lupron, a hormone so far 4 ½ months. I am increasing exercise and sex. I had grown used to hot flashes and low libido caused by the hormone treatment. At this point, I thought to myself I survived menopause and now I am positioned to experience an annual Pap smear test or the birthing experience. Ha-ha.

Assisting with the procedure was the nurse, a CT tech., an equipment technician and a representative from Augmenix, the company that makes and distributes SpaceOar. My physician who is a radiation oncologist has managed a number of clinical trials. So, I wasn’t sure if the well-dressed, good-looking woman from Augmenix was monitoring his work or considering him to lead a new clinical trial with the company. After cleaning me up, I was provided a topical anesthetic to numb the surface and another anesthetic injection. I watched the procedure on the CT screen. The needle went along the very small space between the prostate and the rectum. I didn’t feel any pain outside of the initial puncture. At a little past midpoint of the prostate, the gel was injected. This was the first real pain which was about a 6 on a scale of 10. I was told that the pain would lessen once the needle was removed and it did. The nurse said I did well.

After the procedure, I could still feel the added pressure from the injected gel, but my only pain was a slight burning in “the taint” area. I was glad my wife had come along to drive us home, as I was a little dizzy. The next day I felt fine.

Although additional clinical studies are needed if the SpaceOar injection helps to reduce any radiation side effects it will be worth it. According to my follow-up, T3 MRI the interval placement of hydrogel in between the prostate gland and the rectum appears appropriately placed and measures approximately 4.7 x 1.6 cm in AP and AP dimensions, respectively.

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68 yrs.,79.2 Gy in 44 fractions beginning 9.18.18 PSA .012, 8.12.18, 1.42 June 18, 2018 (Lupron 5.21.18 & 8.15.18), 12.7 May 2018, 13.7 Jan. 2018, 2.1 May 2012. SpaceOar 9.6.18, testosterone >7, 8.15.18, Tot Mayo 19 ng .17 testosterone Free 6.18.18, Gleason 3+4=7 involving 15% of the right apex and 15% of the right mid, 3+3=6 prostate cancer involving 5% of the left base. Pathology interpretations by John Hopkins, UNM Cancer, and SF Path 3+4=7 or 4+3=7 MD Anderson Proton Center w/o %. T3 MRI 1.8 lesion left side 5P, Neg. Bone Scan. Prolaris test 3.5 consistent with intermediate and a PTEN test negative. Father PC age 78 RT & ADT now 93 yrs. Neurogenic bladder due to lumbar disk disease and recurrent bladder neck contracture with urinary retention man. 20 years doing catheterizations. TURP & scaring 2003, Finasteride 5 milligrams daily since 2002.

The studies aren't showing a lot of benefit, but I'm not sure that's 100% settled.

SantaZia said...

Undressed from the waist down and flat on my back on the exam table, I was asked to put my feet in stirrups which spread my legs apart while the technician lifted my legs high in the air. I am on Lupron, a hormone so far 4 ½ months. I am increasing exercise and sex. I had grown used to hot flashes and low libido caused by the hormone treatment. At this point, I thought to myself I survived menopause and now I am positioned to experience an annual Pap smear test or the birthing experience. Ha-ha.

Thanks for letting me have a good laugh. I had a different procedure this week (prostate volume study for upcoming LDR), and had a similar stirrup experience. I survived, just barely as the hips didn't spread as wide as the doctor preferred, but your description and comparison made me shout "exactly!".

My wife, who has been extremely supportive, manages to still kid me with a "welcome to my world" comment when I mention getting in touch with my feminine side with various components of this treatment.

I was also considering Space OAR for EBRT, but got reference from Tall Allen for one clinical trial where findings for rectal side effects were very close for patients with SpaceOAR and without. From what I understand it also depends on type of treatment. For example, it may make sense for SBRT where high dose radiation present for extended period of time, or IMRT to replace rectal balloon procedure, but it may make less effect for IGRT. I spoke to local radiation oncologist and he pointed that most of his patients treated for prostate cancer with IGRT did not use it.

I also had Brachy Boost, I wasn't to happy about getting it and have had quite a bit or side effects but at the end of it all its better than dying I started my PSA @ 14 and thought im only 10 weeks post EBRT my last PSA was 1.32 so If I get more y ears out of this I don't mine peeing a bit more than normal

John

Both RO’s guiding my treatment recommended it, basically came down to why not, if it helps as some studies show in the out years great. If it has no effect as other studies appear to show, but has no side effects from having it then not the first treatment failure nor the last. It’s a one time deal, all in with RT, again why not?