SpaceOAR causing issues

Posted by imbimbo @imbimbo, Feb 16, 2023

I just spoke with my urologist today and he indicated that the hospital affiliated with his practice is no longer using SpaceOAR. Doctors in various parts of the country have seen complications. I attempted proton therapy last summer at Sibley Hospital and had the spaceOAR inserted. I for whatever reason got a horrible infection two weeks after it was inserted. I presumed it was a bad insertion by the doctor who was affiliated with Sibley (not my urologist here in Pittsburgh). So my advice to others who are not aware of this development, discuss this information with your doctor. My urologist as recently as December, 2022 was a proponent of spaceOAR and now he will not do it.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

@johnny8924

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

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

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@kenporter

Looking for input regarding the SpaceOAR (organ at risk) gel. I have been on Orgovyx for about 10 weeks now and starting EBRT in March for 44 treatments. I’m a Gleason 7 (4+3), high risk seminal vesicles invasion, Oncologists said he uses the SpaceOAR (between Prostate & rectum) 95% of the time, but not in my case. Said it would cause problems with the amount of cancer I have in that area of my prostate. Of course I’m concerned with too much radiation getting to my rectum. Wondering if anyone here has had the same experience or concern. Appreciate any input. Ken

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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.

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@petep

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.

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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.

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@kenporter

Looking for input regarding the SpaceOAR (organ at risk) gel. I have been on Orgovyx for about 10 weeks now and starting EBRT in March for 44 treatments. I’m a Gleason 7 (4+3), high risk seminal vesicles invasion, Oncologists said he uses the SpaceOAR (between Prostate & rectum) 95% of the time, but not in my case. Said it would cause problems with the amount of cancer I have in that area of my prostate. Of course I’m concerned with too much radiation getting to my rectum. Wondering if anyone here has had the same experience or concern. Appreciate any input. Ken

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That's tough to hear. If you have rectal bleeding after radiation therapy, make sure you coordinate any treatments with your radiation oncologist. When I had my Proton Therapy, I was told not to have any colonoscopies, or other "fishing around" in there by anybody without them coordinating with my treating doctor at UFHPTI. There's a reason for this. Most proctitis symptoms will take care of themselves without intervention by a gastroenterologist. The rectal wall likely is healing itself and very susceptible to damage by unnecessary probing around. Be cautious. Be careful. Before my treatment, UFHPTI made sure I had undergone a recent colonoscopy so a repeat wouldn't be necessary for 4 to 5 years. Again, it is so there's no poking around in there that could cause more damage where the proctitis will likely heal on its own if left alone. So please coordinate with your treating radiation oncologist. In my case it is Dr. Bill Mendenhall. He happens to have a background in Gastrointestinal Radiation Oncology, so I'm going with his recommendations. And no, I didn't have a gel spacer inserted because the doctor called it off during the procedure. I had to go with the endorectal balloon. After 10 months, I'm seeing a little bleeding after some bowel movements and suspect a mild proctitis, as does Dr. Mendenhall. I'm keeping him up to date. No interventions are scheduled at this time.

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@kenporter

Looking for input regarding the SpaceOAR (organ at risk) gel. I have been on Orgovyx for about 10 weeks now and starting EBRT in March for 44 treatments. I’m a Gleason 7 (4+3), high risk seminal vesicles invasion, Oncologists said he uses the SpaceOAR (between Prostate & rectum) 95% of the time, but not in my case. Said it would cause problems with the amount of cancer I have in that area of my prostate. Of course I’m concerned with too much radiation getting to my rectum. Wondering if anyone here has had the same experience or concern. Appreciate any input. Ken

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One Year and two months after SBRT.
I had a colonoscopy yesterday. No signs of any radiation burning anywhere. My gastro said it was because of the SpaceOar's protection

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@dgd1953

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.

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That’s not great to hear, but EBRT is a very broad term and different machines have the ability to shape the beam around the rectum, avoiding proctitis.
Also, I have read many posts on this forum alone by men who say that no dietary guidelines whatsoever were followed or suggested by their team- WTF?
When I hear questions like “what’s a no gas diet?” By someone who’s having any kind of radiation it blows my mind🤯

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@ssaftler

I asked about Space OAR with my RO for my upcoming treatments, after hearing about it from a relative who recently underwent radiation therapy for his PC problem and used it. I was told that my provider (Kaiser in Northern CA) does not use Space OAR any longer because of the relatively high rate of problems with it. Reading the comments here, I can see that they have a valid argument and I'll probably be better off without it. Even though it may increase the risk of other problems may be increased without it.

Guess I'll know more in a few weeks, when my external treatment starts. Having brachytherapy on Tuesday to start the process before the external photon radiation starts.

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@ssaftler How are you now more than two years after radiation? I also asked my RO about SpaceOAR before my SBRT April 9-21, 2025 and I was told I that I didn't need it. I was feeling I haven't advocated enough for myself, so I did some reading today and found your post. I don't feel bad now for not insisting on SpaceOAR, knowing that Kaiser doesn't use it same as my cancer center.

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@5galloncan

That's tough to hear. If you have rectal bleeding after radiation therapy, make sure you coordinate any treatments with your radiation oncologist. When I had my Proton Therapy, I was told not to have any colonoscopies, or other "fishing around" in there by anybody without them coordinating with my treating doctor at UFHPTI. There's a reason for this. Most proctitis symptoms will take care of themselves without intervention by a gastroenterologist. The rectal wall likely is healing itself and very susceptible to damage by unnecessary probing around. Be cautious. Be careful. Before my treatment, UFHPTI made sure I had undergone a recent colonoscopy so a repeat wouldn't be necessary for 4 to 5 years. Again, it is so there's no poking around in there that could cause more damage where the proctitis will likely heal on its own if left alone. So please coordinate with your treating radiation oncologist. In my case it is Dr. Bill Mendenhall. He happens to have a background in Gastrointestinal Radiation Oncology, so I'm going with his recommendations. And no, I didn't have a gel spacer inserted because the doctor called it off during the procedure. I had to go with the endorectal balloon. After 10 months, I'm seeing a little bleeding after some bowel movements and suspect a mild proctitis, as does Dr. Mendenhall. I'm keeping him up to date. No interventions are scheduled at this time.

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@5galloncan How are you now? "I didn't have a gel spacer inserted because the doctor" because my oncologist said I didn't need it. I completed my SBRT this past April 9-21, 2025. After 1 week, I'm seeing a little bleeding after some bowel movement or when "it feels there is a need to move bowel but only gas and a little watery blood comes out." I updated my oncologist; it appears this little bleeding is nothing unexpected. I'm keeping an eye if if it gets worse; I was told my side effects would peak 3 or 4 weeks after my last radiation.

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@kenporter

Looking for input regarding the SpaceOAR (organ at risk) gel. I have been on Orgovyx for about 10 weeks now and starting EBRT in March for 44 treatments. I’m a Gleason 7 (4+3), high risk seminal vesicles invasion, Oncologists said he uses the SpaceOAR (between Prostate & rectum) 95% of the time, but not in my case. Said it would cause problems with the amount of cancer I have in that area of my prostate. Of course I’m concerned with too much radiation getting to my rectum. Wondering if anyone here has had the same experience or concern. Appreciate any input. Ken

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I suspect that since I didn't have the gel spacer (failed procedure), I have some radiation proctitis. But it is likely to heal on its own, according to my doctor. We'll see, right? No pain, just occasional bleeding. For instance, after sleeping all night, I got up the other morning and passed about two tablespoons of blood, clotting, etc. But nothing since then. I will fast for a couple of days to give everything down there a rest. I'm thinking I'll stop riding my ebike for awhile too and will figure out some other exercise that doesn't apply any pressure to that region of concern.

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@web265

If that's for @web265 , the answer is no, it wasn't recommended for me and I asked about it before we started.

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@web265 I also asked my oncologist and care team about SpaceOAR. They said that I didn't need it. How was your experience the past 2-1/2 years post-radiation? I'm just prepping my mind to avoid "surprises" if there is something coming up that I don't expect right now. Your experience can help me do that.

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