Gel spacer as part of radiotherapy treatment

Hello David

You are quite right, this is not offered on the NHS ( unless things have changed in the last 3 years). If you can get on to a research trial you might be able to get it at no charge. If things have not changed, it does involve having a general anaesthetic. A neighbour recently told me the cost quoted to him several months ago was about £5000.

we had a friend who had this inserted and had no bowel issues at all but had urine problems.My husband didn’t have it - and had no bowel problems at all but had some urinary urgency for a few weeks! At the time I looked at various stats ( I am not a statistician) and my own very inexperienced conclusion was that the Space Oar does seem effective in protecting the bowel but there is a slight increase in the risk of urine issues.

I read this paper 3 years ago. I am absolutely not an expert on this issue and things might have changed. I would strongly recommend that you look for research papers , NICE updates etc so you can make a well- informed decision for yourself rather than rely on my words!

incidentally , my husband absolutely did not want to have yet another procedure. I wanted him to have it! Obviously, it was his decision to make and I supported his decision. 

HTH

Hello David (DC123) 

The trade name is SPACE-OAR. As it's an American product I can't put the link up - however here's a link to the NICE guidelines:

NICE - Space Oar   Recommendations

I am aware there are a couple of Community Members who have had the procedure and I hope they will reply to you in due course.

I had my Radiotherapy (without Space Oar) in January 2023 and to date all is well.

Best wishes - Brian.

Thank you

I've had the spacer gel procedure done privately, under local anaesthetic. It felt quite similar to the biopsy.

No issues with the procedure, and no issues with RT afterwards.

I do know it's available on the NHS in some trusts now, it's worth asking. 

G

This is one example with useful details, of it being available on the NHS :

www.uclh.nhs.uk/.../series-no-66-reducing-dose-radiotherapy-your-rectum-during-treatment-prostate-cancer-patient-guide-rectal-spacers

In the above they  missed out the answer as to what happens to it  later - it stays in place for about nine months. It is then "safely absorbed by the body"

Hello David. After reading about it I asked the oncologist about having the spacer at our first meeting. She wasn’t very supportive of the idea. That may possibly have been due to the type of radiotherapy she was lining up for me. In my case I had image-guided and intensity-modulated radiotherapy, 60Gy over 20 sessions, on the prostate, lymph nodes and seminal vesicles from a tomotherapy machine. Side-effects to date have been minimal and very manageable. I don’t know how many treatment centres use tomotherapy, which is designed to dramatically reduce the radiation delivered outside the target areas. Other methods may be just as good, or now better. Might be worthwhile adding the way your RT will be delivered into your decision equation?

I have to agree, to some extent, with a cautious approach to use of this type of device. https://pmc.ncbi.nlm.nih.gov/articles/PMC8882263/  (Other opinions are available)

Certainly a good understanding of the way the RT is to be administered is well worth trying to grasp.

I had 60Gy/20 sessions using SGRT, this claims to give a much more accurate placement of the radiation beam - and therefore less potential damage to the surrounding areas. (I have two metal hips to avoid as well)

I had minimal (if any !) side effects side effects from my RT and talking to other patients side effects did seem to be minimal for most. Several people had had experience of RT using non SGRT equipment and they remarked how much "easier" the SGRT was.  It certainly seemed a lot less "aggro" to me, compared to what I was expecting from watching all the videos beforehand .............no tattoos, no enemas - all very easy.

www.uhs.nhs.uk/.../hospital-trust-rolls-out-state-of-the-art-radiotherapy-technology-to-treat-cancer-patients

I have found from this forum that SGRT does seem not to be widely available and it is (was) not funded by the NHS. Hospitals that use it have had to fund it by other means ?

You are always told to ask questions in the lead up to your treatment..........I have far, far more questions after my treatment than I ever had before it !  But having said that - I am 100% happy with my treatment and the way it was administered.

I had my RT 11 months ago and have a 2 yr HT "sentence". The only real side effects have been weight gain and after 15 months of HT the fatigue is really starting to catch up on me now. PSA is 0.02  

Thank you

Thank you. 

Thank you. I have been thinking about asking to meet my consultant again and ask more questions.