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User

Posted 17 Apr 2019 at 12:09

I was diagnosed with localised cancer in mid March. I am currently on a course of Bicalutamide tablets, to be followed by injections prior to external beam radiotherapy beginning in Mid June. My consultant spoke to me about the Spacer (SpacerOAR ) procedure ahead of the radiotherapy sessions. He did point out that the procedure is not available on the NHS and would cost about £2000 as a private patient. I'd be very keen to know if any member has had this procedure and can share their experience of it. Thank you. Terry

User

Posted 17 Apr 2019 at 14:50

See the thread https://community.prostatecanceruk.org/posts/t17923-Has-anyone-used-SpaceOAR-gel

I'm asking my consultant about it too, although since I'm probably having whole pelvis EBRT in case of any undetected micromets, he might think there's a chance it could protect some micromets from the X-rays.

User

Posted 17 Apr 2019 at 16:05

Many thanks, Andy62. Best wishes,

Terry

User

Posted 23 Apr 2019 at 15:26

Originally Posted by: Online Community Member

He said no point for me as I'm having whole pelvis EBRT, which doesn't focus the beam on the prostate, and includes the lymph nodes around the rectum.

To destroy the prostate (whole pelvis EBRT isn't powerful enough to do that), I'm also having HDR Brachytherapy, and being a high risk patient (PSA >= 20 at diagnosis), he doesn't want to risk the spacer pushing micromets away from the prostate during the HDR Brachytherapy. This is exactly what I suspected.

User

Posted 03 May 2019 at 10:53

Many thanks for this, Andy62.

A good friend of mine had the Brachytherapy procedure three years ago and is now as right as rain.I discussed this option with my consultant, but it appears that it wouldn't be appropriate for me given the location of the lesions. So, it's been Bicalutamide tablets (now over), followed by injections prior to a four week course of EBRT beginning in Mid June.

Every best wish.

Terry

User

Posted 27 May 2019 at 17:17

I had it done and it's no picnic. It does hurt a bit but is over quickly. My team does it as a matter of course and it was just part of my prep. The literature, and what I've read says it helps mitigate some of the effects of the RT so I was all for it. From people who have posted, they're generally glad it was done. I start RT in a week so it will be awhile before I know for sure or, if I'll ever really know if it helped or not.

It also depends on whether it will do you any good or not. I'm no expert but others have said their doctors said that because of where their cancer was, it wasn't necessary/it wouldn't help.

Ask more questions about why they think it will help and your specific situation. 2k pounds is a lot of money but weigh it against your quality of life.

User

Posted 16 Jun 2019 at 14:14

Many thanks for this,my friend.

I'm due to have the Spacer procedure next week and so I'll give you an update in due course.

Best wishes.

Hugman

User

Posted 23 Jun 2019 at 23:08

I mentioned SpaceOAR to my consultant again, and he's not quite as against it in my case as he was before, and I'm going to talk with their SpaceOAR specialist about it. I also spoke with one of the SpaceOAR staff who had a stand at the hospital, and she said it also protects the penis bulb to some extent (a particular issue for HDR Barchytherapy as the radioactive source is passed through it each time), although the diagram she was showing me didn't show it under the prostate as you might expect for that to be the case, so I'll get some clarification on that.

In the case of HDR Brachytherapy, spacer insertion is done as part of the operation to insert the catheter tubes into the prostate which take the radioactive iridium pellet in and out. The tubes are inserted first using ultrasound guidance in the normal way (very like a template biopsy). Then the spacer is injected - it must be done afterwards as it would prevent the ultrasound guidance working properly if it was done first.

By the way, I asked the consultant how many catheter tubes are inserted for the HDR Brachytherapy. The answer was "as many as we can cram in" !

User

Posted 02 Jul 2019 at 12:18

Hello again, Andy, and thank you for this. I hope things are progressing for you.

Before updating you on the spacer issue, it's worth pointing out to you the almost incredible decrease in my PSA reading. At the end of January it was 9.98; after the diagnosis of PC in mid March I had a six week course of Bicalutimide tablets, and then a series of six injections of Decapeptyl ( to end in October): my last blood test showed a PSA reading of 0.58 > what a change!

I had the spacer procedure a fortnight ago - general anaesthetic, and no problems at all, other than a slight degree of constipation for a day or so, now gone. Last week I had a follow-up CT and MRI the purpose of which was to check that all was in order with the insertion of the SpaceOAR. On Wednesday of next week I start a 20 day course of radiotherapy (fortunately this excludes weekends).

Best wishes,

Terry

User

Posted 02 Jul 2019 at 17:54

Hi Terry,

We're quite closely in step.

18 weeks on Zoladex has brought my PSA down from 47.21 to 0.15.
The preceding 6 months on wrong dose of bicalutamide only brought it down from 57.82 to 47.21.

I start my radiotherapy on Monday. However, as it's also treating nodes around the rectum (as a precaution, due to high PSA at diagnosis), SpaceOAR is no use for that.

After the radiotherapy finishes, I will be having high dose rate brachytherapy (HDR) and the SpaceOAR, if I have it done, is for that. Since the HDR is only a 33% boost over the radiotherapy, and my bowel is going to get hit by the radiotherapy regardless, it's not obvious to me it will give me much benefit. There's also the downside that it increases the risk of pushing micromets away from the prostate during the brachytherapy, which would cause eventual recurrence. Weighing these up against reduction in bowel disorders later is not an obvious win, hence having a conversation about the pros and cons.

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