SpaceOAR for RT Advice please

User

Posted 08 Jul 2022 at 23:15

Hi, I am looking for any advice if anyone has had the SpaceOAR and what are your thoughts on it please. My Dad has just been diagnosed, he is a Gleason 8 and a T3A, he has a low PSA. He has been advised its either surgery for the removal or RT. Its such a difficult decision and we are trying to make sure he has all the facts. He has met the surgeon and oncologist but he is not sure what option to take. He is worried about the impact to his bowel. I have read about SpaceOAR and we asked the oncologist who advised that this is not an option on the NHS in Scotland. Although he could go private for this, we are trying to get costs for this at the moment. Im not sure how a mix of NHS and private treatment would work together for the RT and prep with the SpaceOAR

Im looking to find out the benefits of SpaceOAR as the oncologist didnt seem to think it was something that he would recommend, but Im not sure if that was due to it not being available on the NHS, so maybe he didnt want to give hope of something thats not available. The first nurse that we saw mentioned that spacers could be used, and so we looked into it but the oncologist was clear that it cant be provided on NHS - im a bit confused after these two conversations.

Does anyone know if there are options to push for SpaceOAR on the NHS and how would I go about this? If this is a possibility?

I really appreciate any advice that anyone can give me. We are trying to read up as much as we can at the moment as its all new to us.

User

Posted 08 Jul 2022 at 23:50

This topic has came up before, I can't remember all the details, but in the interests of giving you the answer quickly and hoping that someone who remembers all the details can fill in the missing pieces later. I think NICE did a trial on this and some members on here did have spaceoar as part of the trial. On balance spaceoar was not considered value for money by NICE. It doesn't mean it didn't work, but the benefits didn't justify the cost. It seems NHS Stafford is still using it.

I have just found this post on the cost.

https://community.prostatecanceruk.org/posts/t23162-Cost-of-Space-OAR-Hydrogel

I think the opinion of members more knowledgeable than me was that it probably wasn't worth paying for it privately.

Dave

User

Posted 09 Jul 2022 at 01:53

I'm in Australia not the land of my ancestors, Scotland but while I had the option of SpaceOar my oncologist discouraged me from the idea. In some situations with RT, if the beams are going to be targetted close to zones that the Spaceoar could protect, it's a good idea. A lot of the time it's possible to administer RT without the risk of it damaging other organs. SpaceOar is not without its own risks.

Every time RT is administered it's vitally important that the patient is set up in such a way as to limit risk of badly targetted zapping. In my case that meant both my team and I had to be very sure that my bladder was full enough before hitting the go button. Techniques vary from place to place but precision and care are paramount.

Jules

Edited by member 09 Jul 2022 at 01:57 | Reason: Not specified

User

Posted 09 Jul 2022 at 01:59

A number of hospitals in England do it on the NHS by applying for funding from the innovation fund - but Scotland doesn't have the same system. If it is any consolation, our local hospital (which is a regional centre of excellence) was offering SpaceOar but has now stopped because the data suggested that it didn't make much difference for most men.

If you are considering paying for the spacer privately, perhaps worth checking first where the cancer is - if it is at the front top of his prostate, nearest the bowel, it may be more worthwhile than if it is at the back of the prostate where there is less risk of bowel damage. It is often pointed out that not everyone has bowel problems with RT but not always explained that this may to be due to the position of the tumour.

It is also important to know that some men are nor suitable for SpaceOar because the spacer would prevent the radiation getting to part of the tumour, so I would want the urologist placing the spacer to reassure me that it is not going to make the RT less effective

Edited by member 09 Jul 2022 at 02:05 | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 14 Jul 2022 at 01:16

Hi Bookworm,

I can tell you that In January 21 I had a spaceAor fit prior to proton beam and it was quite a quick process and not too bad having it inserted. The nurses had my laughing saying I wasn't to expect any sympathy over the position I was in as they had all had babies and other things down there lol.. This was done privately as at the time the Hospital I was under were only allowed to carry out one per week and the oncologist did say after March 21 there was talk of not being allowed this on the NHS, I think with proton beam it was 100% required but other forms of radiation its clearly not. I'm also not 100% sure of the cost as it was all included within the package including the proton treatment but I think its around 7k

All I can say is that I have not had any bowel issues apart from a few cramps and urgency to go the toilet but it's only happened on a few occasions. My PSA was 11 at treatment then fell to 3 six weeks after treatment, it then lifted to 4 which concerned me but the following reading had a decrease and it has continued to fall and I am now at 0.9 on the last check which was approx 18 months after treatment.

Good luck

Edited by member 16 Jul 2022 at 09:16 | Reason: Not specified

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