SpaceOAR concern.

Hey Ken, I had the same question for my RO before salvage radiation (no prostate). He said you can have cancer cells close - but not on or attached - to the rectum; the radiation cannot get to it with a gel spacer in place.
You will have a simulation first and you will be required to take an enema before the procedure. This ensures an empty, smaller diameter rectum which will be digitally scanned into their treatment parameters. Also NO gassy foods 2-3 days before!
In short, the RO can “shape” the beam around the rectum to avoid damaging it while still hitting wayward cells. It is CRITICAL that your no gas/low fermentable fiber diet be strictly adhered to, otherwise your rectal diameter might be slightly larger during treatment and the pre-programmed radiation beams could hit it, causing damage. But the techs should see this when they scan you (every day) prior to initiating treatment.
Be sure to speak to your team about all this because you want to avoid any problems down the road! Best
Phil

Space oats worked fine for me. My gleasons scores were 8,9,10. Had seminal invasion too. I guess it’s where the location of the cancer is on the prostate. Don’t remember any specific diet to follow. It was a piece of cake for me , of course going thru the perineum. My Fanny works fine using stool softeners. This event was back in 2022

In similar circumstances, my RO also considered doing without the SpaceOAR. He then learned I had a history of hemorrhoids and proceeded with the SpaceOAR, explaining that he could work around it and get the radiation to where it needed to be.

Are there any contraindications to doing an enema three weeks after fiducial markers and Barrigel placements to "ensure" a clean rectum for EBRT ?

If your team scheduled you after 3 weeks, is this for your simulation or actual treatment?
If it’s for sim. They know you need an enema so probably OK. If for treatment, it’s even further out in time so again probably OK. But I would definitely ask your RO just to be sure.

If he has concerns because of the amount of cancer you have in that area of your prostate (that he can’t use SpaceOAR or Barrigel), then he should consider using the newer product called BioProtect.

And if he won’t try any of those, there is still the option of the old-fashion rectal spacer - called an endorectal balloon - that can be used.

It's for the actual treatment which is scheduled for February 19.

Probably fine, but DO check with your team. There are NO stupid questions when it comes to your treatment.

I'm scheduled for a prostatectomy next month. When I met with the RO, she said she never uses a spacer. Didn't get into it too much, as I was pretty set to go the surgery route.

I have a friend who also was told he would not need a spacer. He finished his EBRT sessions last summer and has since had two surgical procedures to deal with rectal bleeding.