Info on SpaceOar and your experience

SpaceOar has come up in the consultations with the RO's that I have seen. As I understand it, it is a gel inserted between one's prostate and rectum with the purpose of distancing the rectum from the radiation procedures. One doc seems to suggest there were more SE from using it (thus he does not) than the benefits gained. Another seemed very familiar with using it, but thought it not necessary with my "anatomy" -- that there was already sufficient space between my prostate and rectum.

Seems to me that the most common SE I have heard from those receiving RT is problems with "burning" the rectum tissue and continue bleeding, etc. Admittedly these are persons I know who had RT a decade ago or so and I don't know what kind of RT it was, although I do think one gent had Brachy.

Curious to hear what has resulted from your researching it and especially your personal experience with it.

(If there is already a detailed string on this, please point me in the right direction.)

I had the spacer Gel placed before having LDR seeds implanted. Because my PCa was detected early I chose the seeds over other treatments. I was told the Gel would be absorbed by the body but I cannot remember how long it would take. I remember going in for my first follow up after the seeds were placed and my Urologist did a digital exam. He said he could feel the Gel was still there. I believe my follow up appointment was three months after surgery. I was told with LDR seeds the prostate would somehow weld itself to my rectum. I have no idea if this is true or not.

Everything was great for about a year and a half after surgery. Now I have burning when voiding every day. My Urologist is not worried and is treating me for OAB. I am following up with my RO to see what he has to say.

I read as much as I can on side effects of Brachytherapy long term. Seems there are some people like me but not many. My OAB meds do seem to help with my frequency problem. I need to go every two hours or so. I have always been one to void every two hours or so even before surgery. The new meds have extended this time a bit and reduced the urgency feeling. Burning is still a problem.

In conclusion I am not sure the spacer gel works. I know it was NOT COVERED under BCBS insurance. I will update my own thread when I know more.

Best of luck Serious

I had a SpaceOAR inserted as part of my treatment regimen prior to SBRT (monotherapy) in August of 2019. At that time my RO would not treat without it. It was denied for coverage by BCBS and deemed "experimental". I chose to go forward with it anyway in the event it helped me avoid longterm complications after treatment. The SpaceOAR gel was placed during an outpatient surgery procedure that also included placement of four fiducial markers. The entire process was a non-event for me. In reviewing patient notes from my URO, the gel created a 10-12 mm space between my prostate and rectum. I had the first of five sessions of SBRT about ten days later. I never had any sensation that the spacer was in place. Prior to agreeing to go with the spacer I spent significant time researching the pros and cons. In my personal opinion, a lot of the negative reviews were linked to improper placement. Apparently, it's not a "see one, do one, teach one," procedure. There are variations in anatomy from person to person that have to be considered. In my case, the SpaceOAR company rep was in the surgical suite during my procedure. If I had to guess, the company was making an effort to teach/monitor physician placement of the spacer to counter negative outcomes. Again, this is just my personal opinion. If I were doing this again, I would spend more time researching how these spacers are placed and comparing that to my URO's experience and his/her procedure for placement. I feel as though some placements may not always be as thorough as mine was in an outpatient surgery setting.

I have never had any urinary or bowel side effects from my treatment. I strictly followed the diet plan before and during my treatment. This was probably the biggest disruption to what is "my normal" as I usually prefer to eat foods consistent with a high fiber diet. The low fiber diet is part of the process to minimize gas and movement of the bowels and other organs during treatment. Once treatment was complete, I went back to my normal diet, but it took a few weeks before my bowel habits returned to normal.

It has now been two and half years since my treatment. My urinary and bowel functions are normal and still as they were before treatment. At my first follow-up appointment (3 months) with my RO, he did a digital exam and told me that the spacer had already mostly dissolved. As stated earlier, once I had decided to choose radiation as my primary treatment, I included the SpaceOAR in an effort to help avoid potential longterm problems from radiation. I also believe that the precision of the Cyberknife machine goes a long way to avoid the side effects sometimes found in earlier versions of radiation treatment.

Best of luck to you.

It was under study when I was treated. My RO was an investigator, but didn’t recommend I join the trial. He said they were excellent with IMRT and there would be no problems. Also using the HDR brachytherapy didn’t provide the very long term issues that come with seeds. I have had zero bowel problems over the last 11 years and had the maximum radiation dose.

As I understand the use of Space Oar is not really universally used. Many ROs just don’t use it while others won’t radiate without it.