1. < Prostate Cancer

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.

dandl48 Dave | @dandl48 | Feb 21, 2023
In reply to @drj "Good to know. Thanks for passing this on. This is a highly valuable site for helping..." + (show)
@drj

Good to know. Thanks for passing this on.

This is a highly valuable site for helping the newly diagnosed and those facing treatment decisions, particularly with the sharing of direct patient experiences, and this was informative.

It might be helpful to provide more information on the transrectal biopsies. I assume they were 12 core needle biopsies? The 12 core biopsies really improved cancer detection, but they are far from perfect. Your experience will be very informative. Frankly, I'm somewhat shocked. In addition, I was unaware of the possibility of a perineal biopsy, so thanks.

In my case, they had found the main lesion by an MRI technic*. When it came to doing the biopsies, they had a good idea where to go, and they used that image, and real time ultrasound to guide the needle to that spot and others. I was able to watch the biopsies being done on a screen, with commentary by the doc doing the biopsies.

* I don't know if the MRI was something different from routine, but I do know that prostate MRI is getting better, and they are studying to see if it can become diagnostic almost like a biopsy.

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I went to Mayo's portal to refresh my memory on the number of core needle biopsies and surprise, it was 13. An odd number, whoever was counting messed up, LOL. Also, here is the link to Mayo re transperineal Biopsy. https://www.mayoclinic.org/medical-professionals/urology/news/ultrasound-guided-transperineal-prostate-biopsy/mac-20473283

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drj | @drj | Feb 21, 2023

To repeat the obvious: this site is a great place to learn by sharing our personal journeys. I'll check this out. Thanks.

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kenporter | @kenporter | Feb 8 11:49pm

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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9 replies
heavyphil | @heavyphil | Feb 9 7:43am
In reply to @kenporter "Looking for input regarding the SpaceOAR (organ at risk) gel. I have been on Orgovyx for..." + (show)
@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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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

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ecurb | @ecurb | Feb 9 7:51am
In reply to @kenporter "Looking for input regarding the SpaceOAR (organ at risk) gel. I have been on Orgovyx for..." + (show)
@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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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

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groucho | @groucho | Feb 9 1:04pm
In reply to @kenporter "Looking for input regarding the SpaceOAR (organ at risk) gel. I have been on Orgovyx for..." + (show)
@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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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.

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johnny8924 | @johnny8924 | Feb 10 12:23pm
In reply to @kenporter "Looking for input regarding the SpaceOAR (organ at risk) gel. I have been on Orgovyx for..." + (show)
@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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Are there any contraindications to doing an enema three weeks after fiducial markers and Barrigel placements to "ensure" a clean rectum for EBRT ?

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1 reply
heavyphil | @heavyphil | Feb 11 6:53am
In reply to @johnny8924 "Are there any contraindications to doing an enema three weeks after fiducial markers and Barrigel placements..." + (show)
@johnny8924

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

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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.

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1 reply
brianjarvis | @brianjarvis | Feb 12 7:18am
In reply to @kenporter "Looking for input regarding the SpaceOAR (organ at risk) gel. I have been on Orgovyx for..." + (show)
@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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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.

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johnny8924 | @johnny8924 | Feb 12 10:11am
In reply to @heavyphil "If your team scheduled you after 3 weeks, is this for your simulation or actual treatment?..." + (show)
@heavyphil

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.

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

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