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Is a rectal spacer desirable?

User
Posted 01 Nov 2022 at 08:31

After three years of watchful waiting, it has become necessary to take action to deal with my prostate cancer. After exploring all the options, and taking into account my age, other health issues and the nature of the tumours, I have decided on external beam radiotherapy. I have started with the hormone treatment that precede it - Bicalutamide tablets and had the first Zoladex implant yesterday. The plan will be to start the radiotherapy early next year.


One question I have for the Forum is about the benefits of a rectal spacer during the radiotherapy. I wonder if people who have had radiotherapy have views of the benefits or otherwise of a rectal spacer. Perhaps you had a rectal spacer, or perhaps you didn't and wish you had, or know about someone's experience. This option may not be available to me at my NHS hospital, but would be available if I went privately, so I am interested to understand what is involved with a rectal spacer and whether it is something that is preferable to have.


I'd be grateful for any and all views on this issue.

User
Posted 06 Nov 2022 at 08:44

It does sound like any benefits of Space-or, are pretty minimal, if it helps at all. (Probably more a money maker)
I mentioned it to my Oncologist, he did not rate it very much at all - my Treatment was done at Addenbrooks In Cambridge, & I cannot praise them highly enough, for my treatment.

Edited by member 06 Nov 2022 at 08:45  | Reason: Not specified

User
Posted 01 Nov 2022 at 21:52
I met my consultant for the first time yesterday. I am scheduled for brachytherapy in three weeks time. I asked him if a hydrogel spacer was recommended and he said no. He is one of the top consultants in the area but he did not give any reasons. The NHS hospital I am getting treated at ran a trial with the spacers which is now discontinued.

FYI I costed the fitting of a spacer privately and was quoted a price of £7136.00🤔 I don’t know if that included VAT!
My main concern if you got this done would be the coordination between the NHS timeline and the private sector timeline.
Rgds
Dave
User
Posted 02 Nov 2022 at 02:11

Wow, the price has certainly climbed over the last 3 years!


Don't assume that Spaceoar would necessarily be useful to avoid colateral damage. It might in some circumstances and your oncologist should be able to give you an assessment of whether that means you, or not.


With a G9 score I was prepared to pay for the insert but my oncologist suggested it wasn't necessary. This turned out to be correct. Despite being zapped with 81gy over 45 sessions I have had no side issues of any sort in the two years since my RT finished.


These inserts can have issues too, like shifting their position, so while we're all willing to do whatever it takes to get rid of cancer, there's a good chance a spacer might not be useful for you. I've seen it suggested that as RT gets more accurate and hence less likely to cause rectal damage, the need for a spacer goes down. Where it once looked as though spacers would become a standard procedure, their use seems to be on the decline now.


Jules

User
Posted 02 Nov 2022 at 14:54
Our hospital, also a uro-oncology centre of excellence, trialled SpaceOar through the NHS innovations fund but discontinued it as the results were not good enough to justify cost. One problem is the position of the tumour - if the tumour is at the front of the prostate (facing the bowel), the SpaceOar can prevent the RT from reaching all of the treatment area.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Posted 01 Nov 2022 at 21:52
I met my consultant for the first time yesterday. I am scheduled for brachytherapy in three weeks time. I asked him if a hydrogel spacer was recommended and he said no. He is one of the top consultants in the area but he did not give any reasons. The NHS hospital I am getting treated at ran a trial with the spacers which is now discontinued.

FYI I costed the fitting of a spacer privately and was quoted a price of £7136.00🤔 I don’t know if that included VAT!
My main concern if you got this done would be the coordination between the NHS timeline and the private sector timeline.
Rgds
Dave
User
Posted 02 Nov 2022 at 02:11

Wow, the price has certainly climbed over the last 3 years!


Don't assume that Spaceoar would necessarily be useful to avoid colateral damage. It might in some circumstances and your oncologist should be able to give you an assessment of whether that means you, or not.


With a G9 score I was prepared to pay for the insert but my oncologist suggested it wasn't necessary. This turned out to be correct. Despite being zapped with 81gy over 45 sessions I have had no side issues of any sort in the two years since my RT finished.


These inserts can have issues too, like shifting their position, so while we're all willing to do whatever it takes to get rid of cancer, there's a good chance a spacer might not be useful for you. I've seen it suggested that as RT gets more accurate and hence less likely to cause rectal damage, the need for a spacer goes down. Where it once looked as though spacers would become a standard procedure, their use seems to be on the decline now.


Jules

User
Posted 02 Nov 2022 at 14:54
Our hospital, also a uro-oncology centre of excellence, trialled SpaceOar through the NHS innovations fund but discontinued it as the results were not good enough to justify cost. One problem is the position of the tumour - if the tumour is at the front of the prostate (facing the bowel), the SpaceOar can prevent the RT from reaching all of the treatment area.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 02 Nov 2022 at 18:24
Thank you all for this input, which I find very helpful. I have a little time before the RT starts (probably February or March, I was told) so I have time to think about it further based on your helpful input. If any others have views, I am very open to hearing them.

Thank you all again.
User
Posted 04 Nov 2022 at 22:11

I wouldnt wait that long to start; all it takes is for ONE cell to escape and then you won't get cured. Start as soon as you can! Trust me - I know from my experience.

User
Posted 04 Nov 2022 at 22:52

Originally Posted by: Online Community Member


I wouldn't wait that long to start; all it takes is for ONE cell to escape and then you won't get cured. Start as soon as you can! Trust me - I know from my experience.



 


Rick has started taking Zoladex, so the wait is  quite standard, not a delay. It will result in his psa dropping and the cancer will be "starved" due to the drop off in testosterone. It's desirable to have the psa level low when you start RT


Jules 

User
Posted 05 Nov 2022 at 08:46

Originally Posted by: Online Community Member


I wouldnt wait that long to start; all it takes is for ONE cell to escape and then you won't get cured. Start as soon as you can! Trust me - I know from my experience.



It's standard to be on HT for between 3 and 6 months prior to RT; doing so makes the RT more effective. 


Best wishes,


Chris


 

User
Posted 06 Nov 2022 at 08:44

It does sound like any benefits of Space-or, are pretty minimal, if it helps at all. (Probably more a money maker)
I mentioned it to my Oncologist, he did not rate it very much at all - my Treatment was done at Addenbrooks In Cambridge, & I cannot praise them highly enough, for my treatment.

Edited by member 06 Nov 2022 at 08:45  | Reason: Not specified

 
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