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SpaceOAR NHS availibilty

User
Posted 29 May 2019 at 22:20

Have just seen the Media news that spaceoar is going to be made available to 12 NHS hospitals.  I was with my Radiation/Oncologist team today for measure up/scan prior to starting radiation end of June.  My oncologist was clear that at his hospital would not be using/available spaceoar for at least 12/24 months.  He was not very forthcoming when i asked if i could change to another hospital that is using the gel procedure.  How do i find what hospitals are using spaceoar and if so can i change to a another area assuming they would take me.  It just seems i have a much better chance of avoiding collateral damage by using gel. Any thoughts on benefits of gel would be interesting. 

User
Posted 29 May 2019 at 22:20

Have just seen the Media news that spaceoar is going to be made available to 12 NHS hospitals.  I was with my Radiation/Oncologist team today for measure up/scan prior to starting radiation end of June.  My oncologist was clear that at his hospital would not be using/available spaceoar for at least 12/24 months.  He was not very forthcoming when i asked if i could change to another hospital that is using the gel procedure.  How do i find what hospitals are using spaceoar and if so can i change to a another area assuming they would take me.  It just seems i have a much better chance of avoiding collateral damage by using gel. Any thoughts on benefits of gel would be interesting. 

User
Posted 07 Jul 2020 at 12:41
Wow! I think this will be the last time I come here to take part. As someone who is sh***ing themselves over PC (yes I hear the don't worry/it's better than some other cancers/It's slow growing kinda Platitudes), but this is happening to me. The reason I would prefer surgery (but I can't have now) is due to the worry about possible rectal problems with RT. If a spacer between the prostate and rectum can reduce those possible side effects then I want to give it a go. I'm not worried/bothered about ED (that is likely going to happen with either option) though I would rather not have it obviously. This treatment has been around for a few years now, I've yet to see a bad report. Along with IGRT/IMRT RT that is available at my Hospital, I would hope there is a much better outlook for my treatment with the spacer. So I'll pay even though it makes a big dint in our retirement funds. My point was that it is said to be available on the NHS, yet it wasn't for me or most others currently.

I came here for support, not to be told that the options I want to take are dubious at best, cheers

and goodbye
User
Posted 09 Dec 2020 at 22:41

OK this really is my last post here! It seems every time I post (twice) I get trolled by a person. The last time I even had another person email me to back off because I had the nerve to answer her.  With regard to my post encouraging anyone going for RT to look into having a spaceOAR. Yes not everyone will be suitable, but as I said my Onc knew what my plans were (i.e coz we had discussed it and I'd even asked if i could get at my hospital).  So I think that anyone considering it would also discuss it with their Onc', not just tell them they'd had the op in expectation! I'm pretty sure the Onc' will tell them if the procedure would help them.


As said last time this would be my last post (though didn't actually delete my account) well i will this time, I will get the hell out of this place. Apologies to you guys, with PC and I hope everything goes the best it can for you. Please don't bother responding because my account will be deleted. Well done "Karen" who always knows best.

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User
Posted 30 May 2019 at 02:55

You might not want to wait that long - the innovation fund has done their bit and now the 15 locality science networks will decide which hospital gets the money I think. Then people will need to be trained, I assume. I can't see it being available on the NHS in the near future so you might need to talk to your doctors about the impact of delaying. You would also need to clarify whether you would even be suitable for SpaceOar - it will only be offered to men for whom the gel will not get in the way of areas that need zapping.


You could try contacting the science network for your area to ask whether they have plans / timescales in place yet?


http://atlas.ahsnnetwork.com/ 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 30 May 2019 at 07:22

As I reported in my own thread on the subject a few months ago, my oncologist at the Clatterbridge Cancer Centre on the Wirral told me that they're planning to start trialling the procedure there fairly shortly. I can certainly see it becoming a standard part of RT prep for suitable patients in the next few years.


I made the personal decision not to delay my RT by trying to find somewhere to have the procedure carried out (although my insurers had agreed to fund it) after being unable to find somewhere it could be done in the NW of England. As things turned out, I had few side-effects during my RT (although late-onset effects are, of course, still an unknown quantity).


Best wishes,


Chris

Edited by member 30 May 2019 at 07:27  | Reason: Not specified

User
Posted 02 Jun 2019 at 10:30

anyone had experience of Genesis care radiation.  It seems to be a much finer approach to radiation with less chance of collateral damage. would welcome any thoughts.  

User
Posted 02 Jun 2019 at 13:13

Looks like it's just a private provider of radiation and other cancer services.


A common difference between NHS and private external beam RT (EBRT) is that NHS typically performs the X-ray imaging for accurate positioning the first 3 times and then once a week thereafter, on the assumption that the prostate doesn't move more than the 5mm overspill margin, whereas private providers image every time, and can have a smaller X-ray overspill margin and therefore less collateral damage. (Maybe thing like bowel contents are not such an issue in this case - I don't know.)


I did a tour of a private provider (different one than you mention) a week ago with the Reading Prostate Cancer Support group. They do about 5 EBRT sessions a day in their LINAC, so they have a lot more time to setup and do the imaging every time (and time to allow us in to see the facility).

User
Posted 02 Jun 2019 at 14:40
This just seems to be an explanation of the difference between IGRT and IMRT. Lots of hospitals do IGRT on the NHS - St James's in Leeds certainly does. Interestingly, St James's also offered SpaceOar for a while but have stopped due to lack of take-up; I am hoping that they will be one of the 12 hospitals named by the local networks.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 29 Feb 2020 at 10:35

Originally Posted by: Online Community Member


Looks like it's just a private provider of radiation and other cancer services.


A common difference between NHS and private external beam RT (EBRT) is that NHS typically performs the X-ray imaging for accurate positioning the first 3 times and then once a week thereafter, on the assumption that the prostate doesn't move more than the 5mm overspill margin, whereas private providers image every time, and can have a smaller X-ray overspill margin and therefore less collateral damage. (Maybe thing like bowel contents are not such an issue in this case - I don't know.)


I did a tour of a private provider (different one than you mention) a week ago with the Reading Prostate Cancer Support group. They do about 5 EBRT sessions a day in their LINAC, so they have a lot more time to setup and do the imaging every time (and time to allow us in to see the facility).



I was treated at Addenbrooks, Cambridge - & on every one of my 20 fractions, an Xray scan was done first - it is built into the Therapy machine, you are usually moved very slightly after it, then you get the actual therapy following this.

User
Posted 29 Feb 2020 at 10:57

Bob,


I think all the main centres now do accurate positioning every time, certainly those using VMAT* (such as Varian RapidArc) LINACs with built-in cone beam CT scan (CBCT scan).

You either have a CBCT scan done every time and used to make minor positioning corrections, or you have fiducial markers inserted, and the CBCT equipment is instead used to take two X-rays at right angles to pick up the markers and do the alignment with those.

*VMAT LINACs treat during a continuous 360 degree sweep, as opposed to the previous generation which treat from a hand full of stationary positions, but not while they are moving.

User
Posted 29 Feb 2020 at 19:41
I WAS going to have gold seeds, injected - but they found I had Calcium in the Prostate, which act as a marker - & spared me one needle, in a place I was not looking forward too ;)
User
Posted 05 Mar 2020 at 09:57

I've had 3 estimates from private hospitals for SpaceOAR insertion. Basingstoke BMI £5000.59 - Southampton "Spire" £4400. (Another in Guildford c:£5400) A lot of money - but it is one's health & future - so I'm tempted. It is very difficult to find any reviews from the many men who have had this done - After effects, pain, effectiveness etc. Good Luck Gents. R.

User
Posted 07 Mar 2020 at 10:03

If I recall correctly, Mount Vernon was in the £3000-4000 range when I was asking a year ago. I didn't get into the detail, because they switched to say I could have it on the NHS trial for free if I was suitable for SpaceOAR, but for medical reasons (being high risk prostate cancer), it was later deemed not suitable for me.

User
Posted 03 Apr 2020 at 18:50

Does anyone know What nhs hospitals are offering this prior to Radiotherapy?

User
Posted 05 Jul 2020 at 13:50

I have bitten the bullet and opted to go for SpaceOAR via my local Hosp Spire it's going to cost £4525, ouch!


I had wanted to go the surgery route but a bleed on the brain, meant that the surgeon wasn't willing to risk it, as I would be inclined 25 degrees head down and blood would be going to my head. So I only really have the Radio Therapy (RT) option (which I didn't want to to do because of the complications that may/can occur especially with the rectum)


So having found out about the spacer I wanted to have that inserted before treatment. I had hoped that I could get it on the NHS but I couldn't find a NHS hospital, at least nearby (Leicestershire) that does it. A bit miffing because if the spacer works as it is claimed (In clinical trials, SpaceOAR has reduced side effects such as bleeding from the rectum, pain, discomfort, and changes in bowel habit by between 60 and 80%. Some recent studies have also shown an improvement in erectile function compared to patients who don't have SpaceOAR.) then I would be possibly saving the NHS from any remedial procedures needed to treat the possible side effects from RT. not to mention the benefit to the patient in terms of quality of life. I have also read that the NHS can provide this service in an article dated May 2019  https://www.england.nhs.uk/2019/05/nhs-funds-tech-to-protect-prostate-cancer-patients-during-radiation-treatment/ 


I wonder if it would be worth getting a petition going to help future PC sufferers opting for RT to have as an option throughout the NHS regardless of area? Perhaps this is something Prostatecanceruk.org could organise and advertise with all it's members and their relatives?

Edited by member 05 Jul 2020 at 13:53  | Reason: added "throughout the NHS regardless of area"

User
Posted 05 Jul 2020 at 14:15

NHS hospitals who have surgeons trained in the procedure get a small number each month. These will mainly be the main cancer centres, but there are some district general hospitals who now have that expertise too. They have to decide how to use them. They are most likely to be used on patients with existing bowl problems first.


Your price doesn't seem bad. It was around £3500 privately 18 months ago, then shot up to £6000 as more people became aware, but is probably dropping as more places do it, although I haven't done a price comparison in the last year.


I was going to pay to have it privately (when it was £3500), then my hospital said I could have it on the NHS as they'd been given a load to try out, then said as a high risk patient, they wouldn't recommend it, so I didn't have it in the end.

UCLH are running a trial of it on high risk patients, called ICEMAN.

Edited by member 05 Jul 2020 at 14:21  | Reason: Not specified

User
Posted 06 Jul 2020 at 08:56

Great you mentioned UCLH. I looked at this before I went down the surgical route. Guys Cancer Centre at London Bridge and Royal Marsden might be worth scoping out too maybe? 


TG

User
Posted 06 Jul 2020 at 09:32
I can't see much point in starting a petition - firstly because the point of the innovation fund is to make new treatments more widely available so that they can be further assessed for efficacy and cost effectiveness; it is up to individual CCGs / NHS trusts to decide whether to apply to their local hub. And secondly, maybe I am feeling a bit negative this morning but my guess is that COVID is going to break the bank and we will all find it harder to get critical care on the NHS in the future, let alone treatments that are non-critical.

The only source of data suggesting that SpaceOar reduces the risk of ED seems to be the manufacturer. I struggle to see how a spacer between the prostate & bowel can protect the nerve bundles covering the prostate; although their (non peer reviewed) stats are good, I would want to see whether there was any bias ... e.g., were the men selected for SpaceOar younger than the average RT patient, how old was the data used for the baseline / control group (and therefore, did those men have IGRT / IMRT or older, more scattergun RT), and was there a difference between the two groups re hormone treatment / libido suppression?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 07 Jul 2020 at 12:41
Wow! I think this will be the last time I come here to take part. As someone who is sh***ing themselves over PC (yes I hear the don't worry/it's better than some other cancers/It's slow growing kinda Platitudes), but this is happening to me. The reason I would prefer surgery (but I can't have now) is due to the worry about possible rectal problems with RT. If a spacer between the prostate and rectum can reduce those possible side effects then I want to give it a go. I'm not worried/bothered about ED (that is likely going to happen with either option) though I would rather not have it obviously. This treatment has been around for a few years now, I've yet to see a bad report. Along with IGRT/IMRT RT that is available at my Hospital, I would hope there is a much better outlook for my treatment with the spacer. So I'll pay even though it makes a big dint in our retirement funds. My point was that it is said to be available on the NHS, yet it wasn't for me or most others currently.

I came here for support, not to be told that the options I want to take are dubious at best, cheers

and goodbye
User
Posted 07 Jul 2020 at 13:23
I am sorry if that was how it sounded; I am all for fighting for the best option you can get & that was what we did when my husband was diagnosed although we ended up having to self finance to do it. If he was having RT now, I would certainly want him to explore whether SpaceOar could be an option - the research data on reduction of bowel symptoms is unequivocal.

My comments were related only to whether there should be petitioning for it to be available free for all men on RT / brachy (I believe it would be wonderful and perhaps will happen eventually but is simply too expensive at the moment when in many areas of the country, they can't even offer proper scans yet) and whether SpaceOar can reduce the risk of ED.

Don't stop logging in - I wasn't saying your options are dubious; just that the capacity to make it available to all on the NHS is probably a long way in the future.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 07 Dec 2020 at 19:23

Thanks to all who posted.  I am a 74 year old fit except for the prostate cancer and and getting ready for my radio therapy. I am interested in the SpaceOAR as I already have IBS and don't want to make it worse.  Has anybody had the spacer put in privately and then continued with the NHS radio therapy?  I live in the sticks and my local hospitals are not going to be geared up for the trial and I can't find hospitals that offer it.

Edited by member 07 Dec 2020 at 19:24  | Reason: Not specified

User
Posted 07 Dec 2020 at 23:38

Hi..    are you saying that the NHS have not offered this as I know that it is available for sure in the South Tees and Newcastle upon Tyne area.    Many of the Urologists work in the Nuffield Hospitals and this is something that is offered.    Reading about it I think its seems prudent to have this in place before any Radiotherapy

User
Posted 08 Dec 2020 at 01:12
SpaceOar is only available to a limited number of men in a very limited number of hospitals- the main centres of excellence were able to bid to the innovation fund to trial it. Where I live, the NHS trust was a pilot but had already stopped offering it before Covid hit.
I suspect that even if it is available in your area as part of the innovation fund, the issue right now will be availability of operating theatres and high dependency beds plus the risk of bringing someone into hospital for non-essential surgery. In many areas of the country, all NHS elective surgery is being done at private hospitals to ease pressure and SpaceOar may not be something the relevant private hospital can offer.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Dec 2020 at 01:51
I had a non-urgent and non-essential skin biopsy (not for Cancer - one is enough😉) at Solihull Hospital (Tier 3) yesterday, and I only waited about three weeks.

The car parks were as full as ever, and it seems there at least, things are getting back to the ‘new’ normal, like the government has suggested they ought to.

A few cursory questions, all variations on ‘Have you got the plague?’, and straight into the operating theatre.

It seems Panic Plague Paranoia is subsiding in some parts, but my GP has found it impossible to stick his stethoscope on my chest for a lung problem since May (I think I may have long Covid).

Cheers, John.
User
Posted 08 Dec 2020 at 07:16

The NHS (probably NHS England, but no sure) had 400 SpaceOARs available to use in those patients most likely to benefit, although it's only available in hospitals who have a surgeon trained to install it. Next year, this is expected to be increased to 1400.


If you have IBS, you may be a candidate (it's up to each hospital how they prioritise), but you will need to find a hospital that has the capability of installing it.


EDIT: I'm a year out, it was 400 last year and 1400 this year.

Edited by member 26 Feb 2021 at 08:25  | Reason: Correct dates

User
Posted 08 Dec 2020 at 07:41

thanks, in terms of availability in the NHS hospital I am under they are limiting how many they can do which I was advised was 2 per week and because of this there is no availability until towards the end of January.    I've researched having it done private and this is also possible in my area and I'm just waiting for the appointment.   Everything that I have read tells me it worth having this extra protection.


 


Good Luck to everyone

User
Posted 08 Dec 2020 at 09:21

Thanks to all who answered.  I have not been able to find which hospitals are offering SpaceOAR and it appears Lincolnshire is not on the list anyway.  I am waiting to find out what the Oncologist's view is of it is if I go down the private route.  As for going in to hospital to get it done, every hospital I have been into in the past six weeks for diagnosis etc has not had a problem and as in Phase 1 of lockdown in March, all the private hospitals were commandeered by the NHS and left largely unused so hopefully there is still space there.  If the NHS had not left me 5 years between PSA tests they would have caught me before mine got locally advanced.  Another case of Postcode lottery unfortunately. Celebrities like Stephen Fry do not have the problem the majority of us do and the profile needs raising so that Prostate Cancer is afforded the same priority as Breast Cancer.  The NHS News release is full of what is essentially "political speak" for how well they are doing in respect of Prostate cancer but the rhetoric does not match the action.  Sadly, as ever it is left to the nurses and doctors to pick up the pieces and they are excellent.

User
Posted 08 Dec 2020 at 09:34

Originally Posted by: Online Community Member


thanks, in terms of availability in the NHS hospital I am under they are limiting how many they can do which I was advised was 2 per week and because of this there is no availability until towards the end of January.    I've researched having it done private and this is also possible in my area and I'm just waiting for the appointment.   Everything that I have read tells me it worth having this extra protection.


Have you got a radiotherapy date yet? Are you on hormone therapy yet?


I think the SpaceOAR has to be done a week or more before the planning scan, so any swelling has gone down.


A delay until end of January is unlikely to be a problem. Indeed, longer on the hormone therapy beforehand is likely to bring your pre-RT PSA down lower, which is a good thing, and it doesn't extend your total time on hormone therapy.

User
Posted 08 Dec 2020 at 09:41

Originally Posted by: Online Community Member


The NHS (probably NHS England, but no sure) had 400 SpaceOARs available to use in those patients most likely to benefit, although it's only available in hospitals who have a surgeon trained to install it. Next year, this is expected to be increased to 1400.



 


It is the NHS England 'innovation & technology fund' - hospitals can apply for a share if they wish:-


https://www.england.nhs.uk/aac/what-we-do/what-innovations-do-we-support/innovation-and-technology-payment/ 


As I said above, our NHS Trust offered it early doors but have withdrawn from the programme due to lack of take-up from patients 

Edited by member 08 Dec 2020 at 09:43  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Dec 2020 at 14:24

Originally Posted by: Online Community Member


 If the NHS had not left me 5 years between PSA tests they would have caught me before mine got locally advanced. 



The NHS left me for seven years between PSA tests; 2.2 rising to 16.4 seven years later.


A locum GP in the meantime even refused a request for a DRE when I was on his couch in my underpants for abdominal pain, saying ‘We don’t do that these days’, which was news to the urologist I was referred to, following my raised PSA, who immediately started donning a rubber glove...


The negligent locum GP has disappeared back to the sub-continent, and I am cancer-free (for now🤞), so not all bad.


I would definitely go with SpaceOar if you can get it one way or the other.


Best of luck.


Cheers, John.

User
Posted 08 Dec 2020 at 15:09

I can only tell you of my experience with locally advanced PC. Initially wanted to go down the surgery route, but sepsis from the biopsy and 2 weeks later a bleed on the brain, Has meant that the surgeon was unwilling to risk surgery (in case I had a repeat bleed whilst under). So RT was my only option. Which I didn't fancy due to all the possible side effects (especially to the bowel). I'd read about SpaceOAR, and wanted to go with it. My health authority didn't do the procedure. But a local private one did. So I arranged to go private (£4500 ish), letting the Onc' know that was what I planned. The procedure was done (took a couple of hours or so in total). Felt a little uncomfortable, more strange at first. That quickly went away in a day or so. Had my planning scan 2 weeks later and then started the course of RT. At a meeting with the Onc' halfway through I asked if he knew if the spaceOAR was doing it's job. He said that looking at the figures with regard to % radiation allowed in other nearby organs. I can't remember all the figures but one stuck out. The radiation allowed was 60%, I received 3%, which the spacer had definitely played a part, there were many % less, not all as big a gap as that though. For me I haven't (touch wood) had any bad side effects from the RT, everything seems working as it should (apart from the effects of the hormones).  Next Onc appointment is between Xmas and New year, it will be the first PSA test results since completing my RT. I would encourage any one thinking about RT to get a SpaceOAR it's the best £4500 I've spent. Though would have been better if I could have had it on the NHS.


 

User
Posted 08 Dec 2020 at 16:41

Originally Posted by: Online Community Member
I would encourage any one thinking about RT to get a SpaceOAR it's the best £4500 I've spent.


 


Anyone whose cancer is not in part of the prostate that would get an inadequate dose of RT because of the gel. It isn't suitable for everyone. 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Dec 2020 at 18:50

Hi Andy, for Stereotactic or proton beam my oncologist has said that I personally will not be put on HT.    As for the procedure you're right in that I'm told first of all after the rectal spacer  has been put in then the following day I will have a  mri scan to be sure it is in the correct place and then it will be at least 5 days before any radiotherapy


 


many thanks for your comments

User
Posted 09 Dec 2020 at 22:41

OK this really is my last post here! It seems every time I post (twice) I get trolled by a person. The last time I even had another person email me to back off because I had the nerve to answer her.  With regard to my post encouraging anyone going for RT to look into having a spaceOAR. Yes not everyone will be suitable, but as I said my Onc knew what my plans were (i.e coz we had discussed it and I'd even asked if i could get at my hospital).  So I think that anyone considering it would also discuss it with their Onc', not just tell them they'd had the op in expectation! I'm pretty sure the Onc' will tell them if the procedure would help them.


As said last time this would be my last post (though didn't actually delete my account) well i will this time, I will get the hell out of this place. Apologies to you guys, with PC and I hope everything goes the best it can for you. Please don't bother responding because my account will be deleted. Well done "Karen" who always knows best.

User
Posted 09 Dec 2020 at 23:36
Gosh - certainly no intention to troll anyone and a bit perplexed now. I just corrected a generalisation - sorry 🤷‍♀️😪
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Dec 2020 at 08:08

Appointment confirmed yesterday after a telephone consultation and everything planned for the 29/12.    I need to go on the 24/12 and be swabbed for covid so therefore will isolate with my wife until the 29/12 (christmas cancelled in our house this year.    Its a small price to pay and my family understand.


A couple of things concerned me and one was that the surgeon said that if I found I could not cope with the procedure with local anaesthetic they would have me back in and do this under general.   Having had 3 sets of biopsies over the years this does not seem too bad.   He said it would be uncomfortable and that he also had a concern that owing to the amount of biopsies (1 x 10 then 2 x 20 samples) he said there could be scar tissue that would prevent this.    I'm sure they need to tell you all of the worst case scenario's so that I least you don't expect everything to run smoothly then its a big relief when it does.


I would love to hear from any guys who have had this under local?


 


 

User
Posted 13 Dec 2020 at 15:12

Thanks Bolinge and others.   I have spent days reading all sorts of reviews plus the comments on here.  Here has been the most up to date and useful.  I have found a consultant who can do both Space and my RT but at some cost, above 19K.  I have my first meeting with him on Tuesday and now have a wealth of questions for him - thanks largely to you. MY real issue is that I can't get advice from my oncologist, even by phone the first consultation is not until 10 Dec - all this is time and life ticking by. My simple question like what are the markers you propose to put in, what type of RA do you use all go unanswered.  Like many of you, my PT is aggressive and advanced but still within the prostate and seminal vesicles.  My PSA was 33.7, which is why I consider that I was left too long between screening.  All available evidence points to 60% of males getting some sort of prostate problem in old age yet that is the very time the system stops screening you.  If that is not agism then I don't know what is.  Notwithstanding all of the above you try to remain positive and crack on.  I just wish I could get more information to guide me and my family's worries. Knowledge dispels fear as they said at parachute school.  Finally, prostate cancer feeds on testosterone (hence the hormone therapy). Left handers produce 20% more testosterone so are we left handers more susceptible?  How many of you are "lefties."

User
Posted 13 Dec 2020 at 15:13

The system has just said I won't get email replyies.  How do I turn them back on?

User
Posted 16 Dec 2020 at 06:09

John, there are other rectal spacers and they are not for everyone. The NHS funding for rectal spacers will run out in March 21, currently NHS England have not decided if they are going to move ahead with anymore funding for this scheme currently. If they do decided to move ahead they will not only consider SpaceOAR as there is a new spacer on the market that is the second generation of these rectal spacers it is called Barrigel. This product is supported by the main AHSN involved with the Innovation funding for spacers in the NHS and is fully acknowledged by NHS England as the alternative to SpaceOAR. However the manufacture of SpaceOAR will have you believe their's is the only product available when there is actually three types available in the UK currently. One is currently being trialled in the private sector but requires surgical intervention to have it put in, it is called Bio Protect, this is mainly being use in proton treatment. The second is Barrigel, Barrigel is put in with LA in a day case unit and finally there is the one everyone knows about called SpaceOAR.


All of these spacers are NOT currently NICE approved however there is NICE guidance available in the IPG590, this is what the clinical teams use when deciding how they are to move forward. I believe that the second two rectal spacers are currently awaiting NICE approval, that I do not believe will be coming forward anytime soon thanks to COVID, however watch this space.


The Barrigel rectal spacer is the only one that is indicated to be used on Prostate Cancer patients up to T3B, SpaceOAR is only indicated up to T2 anything past this the doctors decision. Barrigel will stay in place for around 12 months whereas SpaceOAR will stay in place for about 6 months. the main difference between the two is one is a glue the other is a dermal filler, also the Barrigel product is fully reversible, whereas with SpaceOAR it doesn't come out.


To have a rectal spacer in the NHS a majority of the current NHS sites will undertake this under local Anaesthetic just like a prostate biopsy is undertaken. The main reason for this is cost, also theatre time in the NHS is very sought after and they cannot always get this.


my advise would be do your research on the spacers as their is a lot of inaccuracies out there from PR teams creating spin on their product that carries incorrect information. The best example of this is the recent article in the Mail on Sunday, this article is full of inaccuracies. Also speak to your doctors and nurses they are the professionals when is comes to your treatment options, be guided by them and do your own research on what is best for yourself.


I believe that the Prostate Support group Tackle are to run an article on the Barrigel product very soon..watch this space.


Good Luck with your treatment! 

User
Posted 16 Dec 2020 at 13:12

Ethan, thanks for the info.  I have done a fair bit of research and read the NHS and NICE feed.  I need to get a move on really so am opting to go down the private route for a variety of reasons.  I had a consultation last night and asked about NHS and Space.  It seems that the NHS reluctance is mainly doe to logistics, ie more surgeons needed more staff etc and it ultimately comes down to money.  I will repot my results and experience.


 

User
Posted 20 Jan 2021 at 16:22

you are very welcome

User
Posted 26 Feb 2021 at 08:31

It's looking like the NHS innovation fund will no longer be funding any rectal spacers after 31 March 2021. They funded 1400 SpaceOAR's in the year up to then.


Some hospitals will still have some of their 2020 allocation left because of a significant drop on prostatectomies performed. Others are trying to find alternative local sources of funding, but it seems inevitable that fewer of these will be available on the NHS.

 
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