I'm conflicted

In June of 2022, I had proton therapy + lupron with abiraterone for GG 9 with EPE and cribform. The RO advised against a rectal barrier in my case. I selected the medical center and doctor because they are excellent, so I trusted his judgment. Three years later, I have yet to have any side effects from the RT and my PSA remains < .03.

In the absence of solid clinical trial data indicating that a rectal barrier should be the standard of care in all cases and given the caliber of the RO I carefully selected, it made sense to me to defer to his judgment. That said, it's still a tough decision. Best wishes for your peace of mind with your decision and a positive outcome!
Bill

Same here.

@brianjarvis
I would think the SpaceOar would be even more helpful when having photon radiation as the radiation continues out the body.

I do know (I had Space/Oar) was a warning not to ride a bike as could possible move the gel.

Much went into my decision to still use SpaceOAR Vue even though I was receiving proton radiation with its Bragg-Peak characteristics. It was additional insurance just in case…..

As for not riding a bike after injecting SpaceOAR, recommendations vary. Some say to avoid strenuous/heavy exercise/lifting for a couple of days, and running/jogging for a couple of weeks, and bicycle/motorcycle riding for a few weeks. (The guidance for Barrigel might be different, since it remains sculptable for a while after injection. I’m not sure what the rules are for the newer product BioProtect.)

Wow at Columbia P they strongly suggested it so of course before SBRT I had it inserted-no biggie!

I can never never know what damage it might have avoided. Just makes sense to protect what you can from radiation.

Glen

I had the SpaceOAR gel procedure and completed my 5 SBRT radiation sessions two weeks ago at Mayo. Wow - I can't imagine foregoing the SpaceOAR procedure. Yes, it's early after completing the SBRT's sessions, but I have blood and tremendous rectal pain. I dread each day's first bowel movement.

I acknowledge I'll likely get better and recover. However, it scares me to think how much worse (short term and long term) this could have been if I didn't have the SpaceOar procedure.

I had 42 sessions of IMRT, Nine months after treatment I developed chronic radiation proctitis. It has changed my diet and for a period of 1 1/2 years it limited my daily activity. My urologist told me I could not get the barrier gel because of the location of a metastasis very near the outside of my colon. I would have liked to have skipped the whole radiation proctitis disease and now my gastroenterologist says I'm at risk for colo-rectal cancer.

@kenk1962 :
1. We started differently: You had SpaceOAR, I didn't.
2. Two weeks after SBRT, you have bleeding & rectal pain; a few days after SBRT (late April 2025) I had mucus and some traces of blood on my bowel but no rectal pain.
3. You were thinking how much worse it could have been short-term without the spacer; I was thinking if I wouldn't have had any bleeding at all if I had it.
4. I share your concern about what the long-term side effect(s) will be: (a) In your case, SBRT with spacer; (b) In my case, SBRT no spacer.
5. May I suggest we both update this support group of ours, if either or both of us developed more side effects (in the medium or long term) that may help "newcomers to the club" -- who may at that time be on the crossroads whether to have the spacer or not.
I wish you a fast recovery from your immediate side effect(s).
Best,
Vir

@ededed Am I reading correctly that your IMRT was without the barrier gel? And this put you at risk of colo-tectal cancer?
I ask because (a) I had mucus and traces of blood in my bowel for a few days post-SBRT; and I had no more side effects to report the next two months, but (b) you were okey for nine months then developed chronic tadiation proctitis. (c ) This struck me as a red flag, that maybe it's too early for me to celebrate, I have to see what happens the next seven months, if my bleeding mine weeks ago don't come back as proctitis. I hope not.
Anybody here who had SBRT or IMRT over a year ago, without a spacer between the prostate and the rectal area, but didn't develop proctitis?
Will appreciate hearing from you.
Vir

Some bleeding after radiation is not that troubling. That is called acute radiation proctitis. If it comes back in 8 to 18 months it may be a concern then it can be called chronic radiation proctitis . I also have a genetic mutation that increases my chances of developing colorectal cancer. I call radiation: the gift that keeps on giving! I try to take some joy in each day I wake up!