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!