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I am set to begin proton treatments for my prostate cancer at the end of February in Jacksonville Florida. Not sure if you are aware that there are 39 treatments with this proton therapy and for each one a sort of balloon is inserted and filled with a saline solution to separate the prostate and the rectum. I was offered a new way to space the rectum from the prostate instead of the "balloon method". It is a gel, placed between the prostate and rectum. It's called SpaceOAR hydrogel and it is supposed to push the rectum out of the high dose radiation region. It's new in the U.S. but has been done in other countries, is anyone familiar with this procedure? I am leaning heavily on doing this shortly.
The gel has been used in Australia for several years now. It takes about six months for the gel to be no longer visible on xray following absorption. Thus far no reports of any issues have been reported.
My understanding is that normally (when you’re not doing a “BM”), your rectum is not “round” but relatively flat and flexible and partially lays against your prostate, maybe very slightly wraps around your prostate. Picture an uninflated balloon next to (or slightly laying on) a walnut (your prostate).
Now inflate the balloon and the majority of the balloon’s surface (that had been hugging the shape of the walnut), moves away from the walnut with at the most only one area where the balloon is still slightly tangent (touches.) The result is that the majority of the rectum surface is now farther away from the walnut than when the balloon was uninflated and slightly laying on the walnut (prostate).
Well after long hard thought, I gave my doctor the yes. I will take part in this new in the USA SpaceOAR gel insertion. This is supposed to replace the infamous balloon insertion each time the protons are used to radiate my prostate. This means I now need to have a colonoscopy done ASAP and of course nothing but delays because of BC/BS coverage. They no longer cover my gastro doctor who is affiliated with the Borland Groover clinic. I will update as we progress.
Latest in my quest for the cure, Had my colonoscopy last Friday and all went well. Got the starting lineup for my treatment on Thursday by FedEx. This Monday I am scheduled to have a chest x-ray and an MRI of the pelvic area. Oh and by the way I was left a voice mail from the financial adviser. She said "just a reminder on Monday you will be expected to pay ALL of your out of pocket costs that BC/BS won't cover this year $5,500".
For Tuesday, I am scheduled to have my 4 gold markers inserted into the prostate and the new SpaceOAR Gel inserted.
I had my 1st day workup, which was an orientation of the UF Health Proton facility then met with a financial counselor who took $5,500 which is the 2016 BC/BS catastrophic out of pocket max. Then had a chest X-Ray met with my nurse and went over todays procedure (insertion of SpaceOAR Gel) and then left to have a pelvic MRI with contrast performed. Today I will be getting this SpaceOAR gel inserted. This procedure is somewhat similar to having Brachytherapy seeds placed. From what I gather they seem to be selling tickets to Drs. and Nurses to watch my procedure. I will keep you posted.
Well I am officially in this trial for the SpaceOAR gel instead of having the balloon used for each shot of radiation. I will go into more detail in a later post but I have to say that two other men went before me and came out with out any problems. Me .... not that there were any problems but the local anesthesia that they tried on me did not work. I felt every needle inserted.
I wanted to wait a week before I posted my experience with this new procedure. I currently have NO side effects from this procedure.
Tuesday Feb. 23rd at 13:45 met with Nurse #1. She attached a Tegaderm patch with emla cream to numb the perineum area. I then took 4mg Valium and one 5/325 mg of Lortab. Then I had to sit and wait about an hour for this stuff to take effect. Next I was brought into the procedure room, I laid on my back and put my feet up in stirrups. With the family jewels hanging out three nurses started to prep me and move my testicles out of the way and covered them with a towel. Two doctors and the SpaceOAR representative came in and started to prepare for my procedure. The Doc first inserted a transrectal ultrasound probe into the rectum for guidance of all the needle placements. Next I had many shots of Lidocaine in all areas near perineum and shots into the prostate (supposedly to numb things). They then did the placement of the 3 gold fiducial markers into my prostate via needle insertion of which I felt each needle. Finally the last needle is inserted while they wiggle the ultrasound probe to get a better view for the placement of the SpacerOAR gel, but first they inject a saline solution then the gel.
Had the anesthetics worked it would have been tolerable. Unfortunately for me I felt the pain of every needle. I couldn't wait for this procedure to be over. It was much worse than the prostate biopsy but this was how I felt. Two other men who went before me did not have any pain during this procedure their numbing crap worked well for them. I am a lot larger than these men as I am 6'4" and 200 lbs.
Bottom line a week later I'm glad I had it done since I will not need the famous "balloon" placement for each of the 39 treatments.
I hope this helps anyone else thinking about having this procedure.
I had SpaceOAR before Proton in 2016. I do have loose stools but no incontinence. I guess it does not work perfectly for everyone. Hopefully it worked better for you.
I had the SpaceOAR implanted last October -- before my CyberKnife treatment. It didn't seem to help me much as, I had a bad case of proctitis (pain, diahhrea, bleeding, etc) following my last treatment. Here I am six months later and another bout of proctitis -- but thankfully, much milder. Just a dull pain.
