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Hydrogel (SpaceOAR) botched
I had fiducial markers and the spaceOAR inserted. Two weeks after this was done I noticed blood and pus in my stool and I never had that before. It was diagnosed as an infection in my rectum and sure enough after finally getting antibiotics a month later, the blood and pus disappeared. I was to get 28 treatments of proton beam therapy. I never started it due to the infection and damage to my rectum. My question: how long should I wait before doing radiation and can I use spaceOAR or balooons to protect the rectum. Colonoscopy done six months later confirmed that a rectal ulcer was still present.
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@imbimbo, that sounds very uncomfortable, not to mention frustrating to have to delay treatment. Your question: "how long should I wait before doing radiation and can I use spaceOAR or balooons to protect the rectum?" is best answered by your cancer team.
I'm tagging other members like @cdcfbw @joenfl2017 @rcs @dandl48 @buckeye54 @remoteman7 @wrig1jam who have experience with SpaceOAR hydrogel and/or proton beam therapy.
You might also be interested in this related discussion:
- Carbon Fidicial Marker, SPACEOAR Surgery & Proton Therapy https://connect.mayoclinic.org/discussion/carbon-fidicial-marker-and-spaceoar-surgery/
I had a similar situation in Feb. 2024 I had fiduciary markers and an attempted Spaceoar placement which had to be Aborted because the Spaceoar kit failed. I was told by 2 doctors it wasn’t worth the risk to attempt another Spaceoar placement. So now I am scheduled to have IMRT radiation in June without Spaceoar as long as I pass the test proving my infection is gone. I ended up in the hospital on intravenous antibiotics and then on Cipro for another month. I feel ok now but I am frustrated that so many things went wrong on a fairly easy procedure. Have you been able to proceed with your treatment?
imbimbo: I had spaceoar with no issues but there is another spacer called BioProtect which is supposed to be safer and adds more space between your rectum and your prostate, than Spaceoar. It was approved by the FDA last November.
There’s not only SpaceOAR, but also Barrigel as well as BioProtect (which someone else mentioned) to use as a rectal spacer. The downside to all medical procedures is that the physician has to do it right.
I had a successful Barrigel. IMHO it is a superior product to SpaceOAR as it has unlimited working time vs. SpaceOAR where the two components are mixed will being injected/placed and it polymerizes quickly as it is being directed between the prostate and rectum. This allows the doc an opportunity for better placement. Additionally Barrigel can be reversed (dissolved) if in fact it does end up in an incorrect spot.
SpaceOAR was FDA approved in 2015, SpaceOAR Vue in 2019, Barrigel in 2022, and BioProtect in 2023. Each was the best when it was put into use, and superior in application to its predecessor; that’s how medical advances are supposed to work.
I used SpaceOAR Vue in 2021; at the time, that was the best there was. Barrigel can be sculpted to create a custom fit to one’s anatomy; that’s a definite benefit.
Absolutely.....yet SpaceOAR is still the go-to in many practices.
I am currently undergoing 28 proton beam radiation treatments at Mayo Clinic Phoenix. I have Barrigel placed with no pain or problems but a rectal balloon is being used with each treatment in addition. Are others on here having the same procedure?
I was just recommended the same treatment by the Mayo Radiation Oncologist, I am really reluctant do do this procedure, and 28 proton radiation treatments! I'm only a 4+3=7 Gleason, and I'm leaning towards no treatment at all. My Decipher was 0.38 so low risk of metastasis, and my PSMA came back clear of cancer outside the prostate.I've done all my homework on all the treatments, and the side effects are just too much risk, I'm 70 years old and would not want to be one of the 10-20% that had incontinence, or ED, I believe I can get 5-10 more years at a minimum, and probably 15 according to the ProtecT study, there is no difference in mortality at 15 years whether you do radiation surgery or absolutely nothing. I did not even like the side effects from the transperineal biopsy, ( blood in urine & semen, temporary ED) so I just can't imagine some of the other treatments. Focal treatments like Hifu Tulsa Pro Cryotherapy also have side effects, the last treatment I have not ruled out is Brachytherapy High Dose, done by Dr. Chang at UCLA, he has done over 1500. Again, I may just do AS and stay on the Ketogenic diet to starve the cancer of Glucose. I am much more interested in quality of life than quantity, and prostate cancer really has no symptoms until the last stage of metastasis in the bone, I have a few other health issues that will probably take me before that. Rectal infections, bladder stricture, wearing a catheter, Urinary incontinence, Erectile Dysfunction, NO THANK YOU, why would I put myself thru that, just to gain a few more years at best, and ruin what has been a fantastic life up to this point. Prostate cancer is big business, billions of dollars and the medical industrial complex is geared up to treat, recommending diet & exercise, doesn't pay much. I would be happy to enroll in a clinical study that takes men with Gleason 7 who do absolutely no treatment, and see how it stacks up. There is no treatment that is curative, even at an early stage like mine, I read all the time about how the cancer returns even after Prostatectomy, then they do radiation and hormone therapy, no thanks. Again, I'm 70 if I was 55-60 I would probably have a different opinion.
I am with you. I am 71 with decipher score of .38. I had a targeted biopsy of my three lesions found by a 3T multi parametric MRI. Two lesion benign and one 11mm lesion had one core of Gleason 3 out of the four they took from this lesion. PSA was 6.8. I chose active surveillance and my urologist supported this decision.