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New Technology in Prostate Cancer

by Charles L. Perkins, M.D., Ph.D.

North Florida Radiation Oncology (NFRO) is proven to be a leader in providing comprehensive, compassionate cancer care for men with prostate cancer. Because of this leadership patients in Gainesville and surrounding communities can receive the SpaceOAR® (OAR stands for “organs at risk”) System as part of their prostate cancer treatment plan. SpaceOAR hydrogel is a temporary injectable gel that protects the rectum in men undergoing prostate cancer radiation treatment either with external radiation (IMRT), CyberKnife or even with prostate seed implants. SpaceOAR® Hydrogel is made of polyethylene glycol (PEG), a compound which is commonly found in cosmetics and drugs because it is non-toxic and well tolerated by the body. When first injected SpaceOAR is a liquid however, within seconds, it solidifies and becomes a soft, gel-like synthetic material that expands creating a space between the prostate and rectum. The SpaceOAR product is often referred to as hydrogel because it is composed of mostly water. The SpaceOAR hydrogel remains in place during the entire prostate radiation treatment, but is slowly absorbed by the body over time; at 6 months the hydrogel has completely disappeared.

SpaceOAR became available in the US after results of a phase III trial demonstrated significant reduction in the radiation dose to the rectum in patients who received the hydrogel. This reduction in dose was proven to significantly reduce side effects and the severity of not only rectal, but urinary and bowel toxicity as well. In addition, there was a significant reduction in the sexual side effects from radiation in men who underwent the SpaceOAR procedure.

The hydrogel is placed in a patient before radiation .treatment during a minimally invasive outpatient procedure. While the patient is under local or general anesthesia a small needle is used to insert SpaceOAR into a space between the prostate and rectum. Fiducial markers (gold seeds) used to localize the prostate can also be inserted at the same time. These markers ensure exact localization of the prostate prior to each radiation treatment.

Several patients receiving treatment at NFRO have already taken advantage of the SpaceOAR hydrogel. Cherylle Hayes, M.D. states “When it comes to treating Prostate Cancer with radiation we are always dealing with unintended radiation to adjacent organs. Over the years we have gotten better with improved technology; now I can say we have a game changing technology that allows us to push the rectum away from the prostate reducing the risk of rectal side effects. And in the clinical trial, men that were sexually potent prior to radiation treatment, maintained potency at a higher rate when they received SpaceOAR hydrogel. We are lucky to continue to bring innovation to our community.”

Charles L. Perkins, M.D., Ph.D adds “Treatment of prostate cancer with radiotherapy has often been limited by the toxicity to adjacent organs, such as the rectum, bladder, and penile bulb. SpaceOAR truly is the latest advancement in minimizing those immediate and permanent side effects, taking us to the next level in prostate cancer treatment. Its benefits with respect to long-term quality of life and men’s health cannot be overstated.”