SpaceOAR causing issues

I had spaceoar inserted a month or so ago without any complications. Their web site, https://www.spaceoar.com/, was helpful to me. Two RO’s from the 5 institutions I spoke with, Cornell Weill and the Miami Cancer Institute suggested it’s use right away. I had it done at the Orlando cancer institute and was put out for he procedure. Spaceoar also had a technician in the operating room. I was concerned about the risks but I believe the doctor and the Spaceoar technician helped me feel as if the risks were decreased. I had no side effects other than feeling slightly full for a week or so. That extra 1/2 inch of spacing can make a huge difference in side effects with radiation. I also researched and chose the radiation machine I felt most comfortable with.

I had it done last summer, after being on a low-fiber diet and a Fleet enema. It was done by a urologist with just local numbing. I had no noticeable side effects after about a week. It dissolves in six months. This was at Georgetown. I have no reason to question the procedure.

Did you do proton therapy at Georgetown and if so how many days of treatments?

The placement of my Space OAR failed in October of 2022 and created an ulcer in my anal canal wall. This delayed me getting my proton radiation. I just had my second sigmoidoscopy last week and the ulcer is now healed. I told my urologist at OU back in October of 2022 I will not do another gel placement since the first placement failed. Now waiting to get my proton radiation.

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.

I had five sessions of Cyberknife, combined with six months of Orgovyx. PSA is now negligible. Everybody is different, but in my case the treatment worked as planned.

Currently, it does seem to be the standard to use SpaceOar at most locations… I wish there was more data as to % of procedures that resulted in complications…

dale1k (@dale1k) I also wonder how experienced the Urologist's are with Spaceoar who are having problems? I had it placed 2.5 yrs ago at Mayo Rochester with no problems at all under a local numbing shot.

This is an interesting thread. I got SpaceOar at Mayo/Rochester prior to PBT treatment in early 2020. I had no discomfort and no immediate or subsequent problem with the insertion.

But, very recently a friend here at home was exploring getting SBRT photon treatment. The RO (radiation oncologist) was suggesting getting SpaceOar before treatment. But, apparently they clump patients getting SpaceOar together until they have ~six patients and then one of the two very competent urologist (surgeons) do the procedure when a rep (doctor?technician?) from SpaceOar comes to town. If competent urology surgeons want/need a SpaceOar rep present to do this, it suggests to me that maybe there are more experienced and less experienced doctors doing this process.
So maybe that makes a difference.
I would guess that there are many more patients with successful SpaceOar insertion than those who have had problems. (That doesn't diminish the problems for those who had them.)

jimcinak. I agree that this is interesting, so I'll describe what I know. At UCLA last summer, I was set up for "hydrogel" placement a week or two before the scheduled radiation treatment. "SpaceOar" was not mentioned, but I note that SpaceOar's web site says it is hydrogel. What was described for me was "hydrogel" placement, but I don't think it was SpaceOar. They said the hydrogel was temporary and would dissipate and disappear within 6 months. I experienced no discomfort from the gel, or any sensation it was there.

For the placement, I declined anesthesia or drugs since I was fascinated as to the mechanics of getting a solid into my body non-invasively. Be careful what you wish for. I find out it involves inserting a large needle in the small space between my scrotum and anus....Yikes. How do you do stick a needle there without damaging prostate, rectum, etc.? Quite an "Ah Hah" moment. Turns out the device was just like something you would get at Home Depot for applying a two part epoxy, i.e. a twin tube plunger device where the two parts combine just as just at the injection point, just below my scrotum (I believe); she had to move the family jewels around a few times. Boy, the small needle numbing in three places by a pretty young physician in preparation for the large needle was a humbling and uncomfortable experience (in more ways than one). But the numbing was effective so no white knuckles when she turned to the big guy. Big needle guidance was by ultrasound I think. How did it feel? After the discomfort of the numbing, in places even my wife has not gone, the subsequent sensation was some pressure an a lot of heat. The heat hurt for about 10 minutes. Clearly, this was the heat of the gel formation from the two components. She had not warned me about that. They then left me alone for about a half hour.

So, was it necessary or effective? I was shown the before and after imaging a few days later. My very large prostate was pressed tight against the prostate. Effective radiation of the prostate could not have been able to avoid rectal damage. The hydrogel now separated the two by maybe an inch. Awesome. Thank you for medical progress. Clinically, I have not experience any side effects from the radiation, so I thank the skill of the doctors. Perhaps the skill of the doctor doing the placement is a factor in what patient's experience? However, I do hope she doesn't spend all her time working one foot or less from a male anus.