Extracapsular extension of prostate cancer: Anyone have this?

Not exactly, but Dr Lee (city of hope) declared the gel unnecessary. This was with the five MRI guided. Would Lee have place the gel? in treatment there. I was worried, but no problems since, though radiation takes a while to damage the epithelium.

I presume that you had a scan that showed that your prostate cancer had spread outside of your prostate. If so, my response presumes that your RO knows where the prostate cancer is located outside of your prostate. If your RO knows that your prostate cancer cells have spread to an area where a gel would normally be placed in order to move your prostate away from your rectum, the RO may decide not to use a gel in order to ensure that the radiation treatment is most effective at damaging/killing the prostate cancer cells.

If you have concerns about the RO's plan, I recommend that you seek a second opinion and delay the treatment until you are satisfied that the RO's plan both maximizes the effectiveness of damaging/killing the cancer cells and minimizes radiation toxicity to your rectum and bladder. As others will comment, you want to ensure that the SBRT treatment is performed at a prostate cancer center of excellence and uses image-guided technology with ideally 2mm precision.

In 2021, was diagnosed with GS 9 T3n0 with extracapsular extension (ECE also referred to as extra prostatic extension EPE). I was started on Lupron and abiraterone + prednisone and had proton therapy. My RO explained that because of the ECE, no gel would be used as some irradiation to the rectum slightly beyond the prostate could be beneficial. Almost 2 years later, I have not experienced any negative side effects from the RT done without the gel.

As every case is different, if you feel uncertain, obtaining a second opinion from a RO at a high volume major medical center should be considered.

Best wishes to you for an uneventful treatment and positive outcome. Please keep posting as others may benefit from your experience.

Thank you all for the responses. No more second opinions. I think I am in good hands at UCLA! It is the PA that told me Radiation won't kill all the cancer cells If spaceor gel is placed because of the extracapsular extension.

My guy said the same but i did 21 treatments. In theory the gel sounds great but given the 1 or 2% chance of complications with placing of the gel, it kind of negates the 2 to 4% chance of serious long term rectal issues somewhat. That was the reasoning I was given and I just went with the docs advice.

Thanks, your response is reassuring.

Ozelli,
Thank you. This group is great. Now, I feel like I am not alone!

I insisted on having SpaceOar prior to my 45 treatments with radiation. Other than daily diarrhea (one or two episodes) during the radiation, I experienced no long term bowel or urinary problems after the treatments. I realize that this is a study of ONE.

I am glad it worked for you!

Pretty sure Gel is only used in a Cyberknife type of treatment since it uses very high doses of radiation PER treatment. It would fry the rectum!
IMRT uses much lower doses over more treatment sessions so ‘hopefully’ you do not get the same toxic result; and since it is not precisely targeted and focused only on the prostate it hits a much wider area where malignant cells could be lurking.
The addition of ADT weakens the cancer cells and makes their DNA more susceptible to be disrupted and ultimately destroyed. Hope this helps!