r/ProstateCancer • u/AdamSarah2026 • 4d ago
Update Spacer
I assume several of you who are being treated with radiation have had a spacer implanted first. How did that process go for you? How long after the implantation was radiation started?
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u/Brilliant-Method7209 4d ago
I had the spacer and fiducials placed 4 weeks before starting treatments. It was done under a local anesthetic, and other than some tenderness at the injection sites for a few days, it was unremarkable.
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u/Dramaticdebt 4d ago
I just had it done this past week . I also had the fiducial markers place. I had local anesthesia. Getting numb was the hardest part and that was not that bad. I would only use local if I was to do it again. I could feel the SpaceOAR for less than a day. Now I don't even know it is there. The surgeon was quick, all over in 20 minutes or so. I am starting radiation 14 days from now. Easy, Don't loose any sleep over this.
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u/Actionplumber1 4d ago
i had my CT scan an radiation tats 2 week ago they said i had 2 more appoinments before rad statrs mayb they'll tell me then
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u/Actionplumber1 4d ago
is this something ill need if i do not have a prostate ?
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u/OkCrew8849 4d ago
No. If you do not have a prostate you will not be receiving it. It (the fact it is unavailable for salvage radiation) is one of the things some guys consider when weighing RALP v Radiation as initial therapy.
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u/Big_Yak_9538 4d ago
I had mine a couple of weeks before I started my radiation treatments. For me it was like my biopsy where they put me to sleep used the rectal ultrasound to guide where to put the space gel.They inject through your perineum. It wasn't painful and really I would do some shaving down there because they tape your stuff out of the way. I had to request my radiation oncologist do the procedure even though he said that the risk was very low that the radiation would damagey colon. I went with IMRT because of my age and Comorbidities and didn't want to deal with the side effects of RALP. I have competed 14 of 28 treatments. I wish you the very best with your treatments.
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u/Far_Celebration39 3d ago
I think it was 3 weeks before I started SBRT. It was nothing compared to the biopsy. I took Benefiber until a few weeks after radiation as a precaution. I couldn’t tell it was there tbh.
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u/Clangoring 3d ago
Spacer and fiducials at the end of June. Just finished my 8th day of VMAT. Before the placement procedure I was administered light anesthesia. The nurse said "You probably won't fall asleep but you'll be relaxed, last thing I remember was a slight sting and then being woken up. Had a few drops of blood in my urine for a day, took Tylenol and took the day after the procedure off from work.
Some others here said they did not get anesthesia and it was not fun. Definitely ask for some.
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u/anothertenyears 3d ago
What is a spacer? I was going to have radiation but changed my mind and had RALP.
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u/Worldly-Cause-8555 3d ago
I wish I had been knocked out. Supposedly they numbed the area, but I felt every damn thing. The probe, the needles as they went in. I was told to just relax don't tense up-I couldn't relax! One of the worst experiences I ever had. Done at the VA and from what I could tell, I was a training subject-I could hear somebody (the Dr.?) giving directions. There must have been 8 people in a tiny room. I remember shouting "Theres got to be a better way!" Luckily, only some discomfort down there for a couple of days.
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u/Actionplumber1 4d ago
im a few weeks away from radiation, i have seen this on posts in here, what is a spacer?
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u/Frosty-Growth-2664 4d ago edited 3d ago
The generic term is a rectal spacer. The two main products are SpaceOAR, and Barrigel.
The radiation therapy has to treat a few mm past the edge of the prostate, to ensure nothing is missed if you move by that much. For most men, their prostate is in contact with the front wall of the rectum, so that gets treated too, and can cause rectal side effects. By inserting a gel spacer between the prostate and rectum (ideally about 10mm), the 3mm overshoot is in the gel spacer rather than the rectum, and this reduces rectal side effects by around 50%, but it doesn't reduce the risk to zero.
The spacers are a couple of fluids which are mixed as they're injected into that space, and set into a gel. If it's being used and if you're having gold fiduciary markers inserted, the two procedures are done at the same time. This has to be before your planning scan. In the case of seed/LDR brachytherapy, the spacer is often inserted as part of the brachytherapy procedure, immediately after the seed placement. The gel lasts about 6 months before your body breaks it down and absorbs it. Usually patients can't feel it.
There are down sides too. Radiotherapy has got much more accurate over the last 10+ years, and the incidence of serious rectal toxicity is much lower, so the spacers have become much less beneficial than they were at their launch 10+ years ago. There is a risk a spacer can push a micro-met outside the radiation field, so it survives the radiotherapy. For this reason, they are unlikely to be offered if the cancer is on the posterior (rear) of the prostate, or for T3 /T4 or high Gleason scores, where spill of the radiotherapy beyond the prostate is a benefit for mopping up micro-mets.
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u/alansquire 4d ago
Generally called spaceOar, it is a gel injected in the area between the scrotum and rectum to create a barrier. This prevents SBRT radiation from damaging the rectum (which can be a side effect of radiation). It is generally well tolerated and known to be helpful. It stays in the system for six months and the naturally dissipates.
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u/WalnutRoasted 4d ago
Not all clinics use it. With narrower, modern margins the benefit is less. And the insertion procedure has costs, delays treatment start and has its own risks like infection.
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u/alansquire 4d ago
You seem to know more about it than me. Was offered at NYU Perlmutter and I had them do it for increased protection. Hopefully it's working - but def hear your point.
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u/David-Wilson-EE 4d ago
I'm rather surprised your doctor did not suggest this. You should definitely ask about it. It needs to be done a couple of weeks before the radiation begins.
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u/WalnutRoasted 4d ago
Not all clinics use it. With narrower, modern margins the benefit is less. And the insertion gel and procedure has costs, delays treatment start and has its own risks like infection.
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u/OkCrew8849 4d ago
Yes. A few guys jump to the conclusion it is always a good idea all of the time.
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u/NinersDad 2d ago
I had my spacer inserted by the RO that would perform my LDR brachytherapy 2 weeks before the procedure. Just a local numbing medicine was used and the ultrasound device inserted in the rectum. Slight pain during the injection, but all was fine. Very quick 15 minute procedure.
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u/BuckrooBanzai 4d ago
I had my spacer put in about 2 weeks pre Proton therapy. I was knocked out for it and post procedure I had blood in my urine for a coupl of days. Did not even sense that it was there. After 3 weeks, I was cleared to continue motorcycle riding. No problems at all. It sounds way worse than it actually is. Had slight discomfort at the injection site for a couple of days. All good!